Davenport, Thomas A

Davenport, Thomas A is an individual health care provider with primary practice located at 999 Franklin Ave , Garden City NY 11530-2913. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Davenport, Thomas A can be contacted via phone (516) 742-3404.

Contact Information

Primary practice address
999 Franklin Ave Garden City NY 11530-2913
Phone: (516) 742-3404
Fax: (516) 294-6942
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 214557 New York

Profile Details

NPI number 1174583405
LBN Legal business name Davenport, Thomas A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174583405 NPPES
New York MEDICAID 02620253

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