Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 22DI02776600 | NJ |
Y | 213EG0000X | General Practice | 22DI02776600 | NJ |
NPI | 1003451436 |
---|---|
Provider Name | Dr. Paige M Davis |
First Address | Manalapan, NJ 07726-3437 |
Second Address | Manalapan, NJ 07726-3010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2019 |
Last Update Date | 08/11/2019 |