Provider Demographics
NPI:1184762718
Name:FOX, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 3RD AVE
Mailing Address - Street 2:2ND FL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8114
Mailing Address - Country:US
Mailing Address - Phone:212-362-3470
Mailing Address - Fax:212-362-3496
Practice Address - Street 1:1041 3RD AVE
Practice Address - Street 2:2ND FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8114
Practice Address - Country:US
Practice Address - Phone:212-362-3470
Practice Address - Fax:212-362-3496
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1903632086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01892846Medicaid
NY97E751Medicare ID - Type Unspecified
NY01892846Medicaid