Individual
MONICA AGNES DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5547 W MAIN ST, VERONA, NY 13478-3426
(315) 363-3482
(315) 363-1957
Mailing address
5547 W MAIN ST, VERONA, NY 13478-3426
(315) 363-3482
(315) 363-1957
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003351
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003351
P.A. LICENSE
NY
05
—
01622444
—
NY
Enumeration date
07/05/2006
Last updated
06/22/2015
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