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Individual

LAWRENCE J DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
177 N DEAN ST, SUTIE 207, ENGLEWOOD, NJ 07631-2533
(201) 567-0446
Mailing address
177 N DEAN ST, SUTIE 207, ENGLEWOOD, NJ 07631-2533
(201) 567-0446

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA06641900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0K8870
HEALTH NET
NJ
01
4122282
CIGNA
NJ
05
7449704
NJ
01
P801198
OXFORD HEALTH
NJ
Enumeration date
11/07/2005
Last updated
11/18/2013
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