Provider Demographics
NPI:1932623477
Name:DAVIS, DANIELLE ELIZABETH (MSW)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-4848
Mailing Address - Country:US
Mailing Address - Phone:631-921-9604
Mailing Address - Fax:
Practice Address - Street 1:11 HAUPPAUGE RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-920-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program