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IRA DAVIS MD PLLC NPI 1750410759


NPI Information

NPI: 1750410759
Provider Name: IRA DAVIS, MD, PLLC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 33D0975309

Address:
2627 HYLAN BLVD # C
BOX 10
STATEN ISLAND, NY
ZIP 10314
Phone: (718) 477-4022
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IRA DAVIS, MD, PLLC is a mohs-micrographic surgery dermatology in Staten Island, NY. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. IRA DAVIS, MD, PLLC NPI is 1750410759. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2627 HYLAN BLVD # C
BOX 10
STATEN ISLAND, NY
ZIP 10314
Phone: (718) 477-4022
Fax: (718) 698-9573

The provider's authorized official is Wendy Mann .
The authorized official title is Biller and has the following contact phone number (914) 774-2478.

The CLIA number assigned to this NPI record is 33D0975309 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/5/2007 and was last updated on 7/24/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207NS0135XDermatologyProcedural Dermatology182268NEW YORKNo
2207ND0101XDermatologyMOHS-Micrographic Surgery182268NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P00221021OTHERNEW YORKRR MCR
2E86323MEDICARE UPINNEW YORK
3OH4223OTHERNEW YORKHEALTHNET
482F472MEDICARE PINNEW YORK
5WLP691MEDICARE PINNEW YORK
63K2111OTHERNEW YORKBC
7P2869871OTHERNEW YORKOXFORD ID#

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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