Provider Demographics
NPI:1528401452
Name:DAVIS, ESTHER TIFFANY (DO)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:TIFFANY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:ESTHER
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3411 WAYNE AVE FL 7
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2552
Mailing Address - Country:US
Mailing Address - Phone:718-741-2332
Mailing Address - Fax:
Practice Address - Street 1:3411 WAYNE AVE FL 7
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2552
Practice Address - Country:US
Practice Address - Phone:718-741-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305081208000000X, 2080P0206X, 2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics