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Individual

ELLEN WICKS DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 572-6254
Mailing address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 572-6254

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F330299
NY

Other

Enumeration date
06/30/2006
Last updated
04/10/2008
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