Provider Demographics
NPI:1558552943
Name:DAVIS, RASHEED DOHMAREE (RPAC)
Entity Type:Individual
Prefix:
First Name:RASHEED
Middle Name:DOHMAREE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DIXON AVE
Mailing Address - Street 2:APT 17
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2848
Mailing Address - Country:US
Mailing Address - Phone:631-532-5751
Mailing Address - Fax:
Practice Address - Street 1:82-68 164TH ST
Practice Address - Street 2:QUEENS HOSPITAL CENTER
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-883-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011957-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant