Individual
AISHA ANGELA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
179 ROSELAND AVE, WATERBURY, CT 06710-1411
(475) 323-6601
(203) 755-3109
Mailing address
179 ROSELAND AVE, WATERBURY, CT 06710-1411
(475) 323-6601
(203) 755-3109
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
292654
NY
208000000X
Pediatrics Physician
Primary
73804
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
292654
STATE LICENSE
NY
01
—
73804
STATE LICENSE
CT
Enumeration date
03/25/2015
Last updated
05/01/2023
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