Anika Davis
Individual provider Active NPI Counselor · Rutherford, NJ
NPI 1104530476 · NPPES record last updated Jan 10, 2023
Key facts
- NPI
- 1104530476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 37AC00279400 (NJ)
- Practice address
- 1 Orient Way Ste F502
Rutherford, NJ 07070-2524 - Phone
- (201) 880-0768
- NPI assigned
- Jan 10, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC00279400 | NJ | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 37AC00279400 | NJ | Yes |
Addresses
Primary practice location
1 Orient Way Ste F502
Rutherford, NJ 07070-2524
Mailing address
1 Orient Way Ste F502
Rutherford, NJ 07070-2524
Other providers in Rutherford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.