Provider Demographics
NPI:1033515531
Name:DAVIDSON, ALISON MILES (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:MILES
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:ANNE
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1190 5TH AVE # 1028
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6503
Mailing Address - Country:US
Mailing Address - Phone:212-659-6800
Mailing Address - Fax:212-659-6818
Practice Address - Street 1:1190 5TH AVE # GP2W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-659-6800
Practice Address - Fax:212-659-6816
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1020025363LF0000X
NY341679363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily