# NEW YORK SPINE AND BRAIN SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538392410
- **Authorized official:** DR. RAPHAEL DAVIS M.D. (CHAIRMAN)
- **Authorized official phone:** (631) 444-8070

## Contact information

- **Practice address:** HSC T12 RM 080, STONY BROOK, NY 11794-8122
- **Practice address phone:** (631) 444-8070
- **Practice address fax:** (631) 444-1535
- **Mailing address:** HSC T12 RM 080, STONY BROOK, NY 11794-8122
- **Mailing address phone:** (631) 444-8070
- **Mailing address fax:** (631) 444-1535

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 305171 | NY | Yes |

## Other

- **Enumeration date:** 08/26/2009
- **Last updated:** 11/16/2009