Individual
DR. DAVID TODD ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1838 COMMERCE ST, YORKTOWN HEIGHTS, NY 10598-4400
(914) 962-3500
Mailing address
1838 COMMERCE ST, YORKTOWN HEIGHTS, NY 10598-4400
(914) 962-3500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
160802
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00970489
—
NY
01
—
120894
CIGNA
—
01
—
148653
UNITED
—
01
—
2C5048
HEALTHET
—
01
—
4245064
AETNA - PPO
—
01
—
961517
AETNA - HMO
—
01
—
CK0751
RR MEDICARE
—
01
—
WP483
OXFORD
—
01
—
WS0001194
SELECT PRO
—
Enumeration date
08/24/2005
Last updated
09/29/2011
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