Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 037107 | NY |
Y | 225100000X | Physical Therapist | 2305208544 | VA |
N | 225100000X | Physical Therapist | PT023324 | PA |
NPI | 1003262114 |
---|---|
Provider Name | Elyse Marie Davis |
First Address | Armonk, NY 10504-1436 |
Second Address | Armonk, NY 10504-1436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2016 |
Last Update Date | 14/09/2021 |