Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 213531 | NY |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 25MA07797000 | NJ |
NPI | 1063416501 |
---|---|
Provider Name | Dr. William L. Davis JR. |
First Address | Nanuet, NY 10954-5238 |
Second Address | Airmont, NY 10952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 29/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01948512 | (05) | NY |
0D1365 | HEALTHNET (01) | NY |
132721370 | TAX ID# (01) | NY |
200037035 | RAILROAD MEDICARE (01) | NY |
2176547 | AETNA HMO (01) | NY |
2695H1 | EMPIRE BCBS (STONY POINT) (01) | NY |
2695H2 | EMPIRE BCBS (MONROE) (01) | NY |
2695H3 | EMPIRE BCBS (AIRMONT) (01) | NY |
361012 | MVP (AIRMONT/STONY POINT) (01) | NY |
361012 | MVP (MONROE) (01) | NY |
5902684 | GHI PPO (01) | NY |
5956750 | AETNA PPO (01) | NY |
G93564 | (02) | |
P1310314 | OXFORD (01) | NY |