Individual
FAYE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1617 E 5TH ST, BROOKLYN, NY 11230-6908
(917) 589-5977
Mailing address
1617 E 5TH ST, BROOKLYN, NY 11230-6908
(917) 589-5977
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
63 015797
NY
Other
Enumeration date
02/25/2014
Last updated
02/25/2014
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