Organization
IRA DAVIS, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRA C DAVIS MD (PHYSICIAN)
(914) 288-0500
Entity
Organization
Contact information
Practice address
280 N CENTRAL AVE, SUITE 114, HARTSDALE, NY 10530-1832
(914) 288-0500
(914) 288-0260
Mailing address
280 N CENTRAL AVE, SUITE 114, HARTSDALE, NY 10530-1832
(914) 288-0500
(914) 288-0260
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
182268
NY
207NS0135X
Procedural Dermatology Physician
182268
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2K9111
WEST BLUECROSS
NY
01
—
OH4223
HEALTHNET
NY
01
—
P00221021
RR MCR
—
01
—
P2869871
OXFORD
NY
Enumeration date
02/26/2007
Last updated
10/10/2007
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