Charles Stephen Davis, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

149827 Issued in NY

Practice address

321 Summit Ave
Hackensack, NJ 07601-1429

Phone

(201) 343-2434

Fax

(201) 343-3917

NPI assigned

Mar 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• 321 Summit Medical

  • Internal Medicine Physician
  • Hackensack, NJ
  • NPI 1679865109
  NPD (past) Authorized official
• Housecalls for the Homebound Medicine, P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • Spring Valley, NY
  • NPI 1457614018
  NPD (past)
• Samuel Lupin MD PC

  • Specialist
  • Brooklyn, NY
  • NPI 1861538498
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1689641490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011429",
            "telephone_number": "201-343-2434",
            "fax_number": "201-343-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011429",
            "telephone_number": "201-343-2434",
            "fax_number": "201-343-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHARLES",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "MA49376",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "149827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David P. Bleeker MD
• David Shaker DO LLC
• Allan Brice Davidson, PHARMD
• Marson T Davidson, MD
• Luisa Yoiko Davila, BS, MS, ATC
• Beverly Davison, MD
• Linda Davt, APN
• Saraswati Dayal, MD
• Mayievin De la Cruz
• Justin De la Pena, PT, DPT

• Geriatric Medicine (Internal Medicine) Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Geriatric Medicine (Internal Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.