# ELM MEDICAL, PC

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

## Provider details

- **NPI number:** 1871742387
- **Authorized official:** DR. GORDON CHARLES DAVIS D.O. (PRESIDENT)
- **Authorized official phone:** (718) 253-3322

## Contact information

- **Practice address:** 1723 ELM AVE, BROOKLYN, NY 11230-5306
- **Practice address phone:** (718) 253-3322
- **Practice address fax:** (718) 258-6494
- **Mailing address:** 1723 ELM AVE, BROOKLYN, NY 11230-5306
- **Mailing address phone:** (718) 253-3322
- **Mailing address fax:** (718) 258-6494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 171745-1 | NY | Yes |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | 171745-1 | NY | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2085B0100X | Body Imaging Physician | — | NULL | — |
| 2085B0100X | Body Imaging Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 09/09/2008
- **Last updated:** 09/09/2008