Individual
STEPHANIE DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
26901 76TH AVE, NEW HYDE PARK, NY 11040-1433
(718) 470-3460
Mailing address
45 IRMA AVE, PORT WASHINGTON, NY 11050-2811
(631) 813-9164
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
383496
NY
Other
Enumeration date
02/22/2023
Last updated
12/22/2023
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