Davis, Richard Gary

Davis, Richard Gary is an individual health care provider with primary practice located at 1700 E Jericho Tpke , Huntington NY 11743-5614. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Davis, Richard Gary can be contacted via phone (631) 462-2020.

Contact Information

Primary practice address
1700 E Jericho Tpke Huntington NY 11743-5614
Phone: (631) 462-2020
Fax: (631) 462-2227
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 170977 New York

Profile Details

NPI number 1699771584
LBN Legal business name Davis, Richard Gary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated Sep 9th, 2019 - about 5 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 1699771584 NPPES
New York MEDICAID 01073858

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