Individual
KAISHA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
529 COURTLANDT AVE FL 4, BRONX, NY 10451-5007
(718) 402-2150
Mailing address
1862 WATSON AVE PH, BRONX, NY 10472-5414
(917) 921-5255
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
NY
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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