Active NPI
Brian Davis, LMSW
- Social Worker
- Rego Park, NY
National Provider Identifier
1285018374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 079597
- Practice address
- 9729 64TH Rd
Ste 1FL
Rego Park, NY 11374-2259 - Phone
- (718) 896-3400
- Fax
- (718) 459-5621
- NPI assigned
- Jul 17, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 079597 | NY | Primary |
Addresses
Primary practice location
9729 64TH Rd
Ste 1FL
Rego Park, NY 11374-2259
Mailing address
9729 64TH Rd
Ste 1FL
Rego Park, NY 11374-2259
Phone (718) 896-3400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 079597 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437091200000",
"number": "1285018374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9729 64TH RD",
"address_2": "STE 1FL",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742259",
"telephone_number": "718-896-3400",
"fax_number": "718-459-5621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9729 64TH RD",
"address_2": "STE 1FL",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742259",
"telephone_number": "718-896-3400",
"fax_number": "718-459-5621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BRIAN",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-17",
"last_updated": "2015-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "079597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.