Provider Demographics
NPI:1679707210
Name:DAVIS, ARNOLD N (RPH)
Entity Type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:N
Last Name:DAVIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 RIVERSIDE DR
Mailing Address - Street 2:PHARMACY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1007
Mailing Address - Country:US
Mailing Address - Phone:212-543-5490
Mailing Address - Fax:212-543-5651
Practice Address - Street 1:1051 RIVERSIDE DR
Practice Address - Street 2:PHARMACY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1007
Practice Address - Country:US
Practice Address - Phone:212-543-5490
Practice Address - Fax:212-543-5651
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21950283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital