Individual
GORDON C DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9601 JAMAICA AVE LOWR LEVEL, WOODHAVEN, NY 11421-2295
(718) 641-4900
(718) 641-4905
Mailing address
10149 WOODHAVEN BLVD, OZONE PARK, NY 11416-2300
(718) 641-4900
(718) 641-4905
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
171745
NY
Other
Enumeration date
02/22/2007
Last updated
04/19/2024
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