Individual
STACY DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6 ELKIN DR, LIVINGSTON, NJ 07039-1308
(973) 992-9622
Mailing address
6 ELKIN DR, LIVINGSTON, NJ 07039-1308
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
18KT00911000
NJ
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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