Mahnaz Sullivan-Davachi, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F333492 Issued in NY

Practice address

Prospect Street
Fillkish Correctional Facility Box #307
Beacon, NY 12527

Phone

(845) 831-4800

NPI assigned

May 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mdavachi@hiemail.healtheconnections.org

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.

• American Hormones, Inc

  • Clinical Medical Laboratory
  • Poughkeepsie, NY
  • NPI 1639309578
  NPD (past)

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1740448604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 836",
            "city": "GLENHAM",
            "state": "NY",
            "postal_code": "125270836",
            "telephone_number": "845-440-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PROSPECT STREET",
            "address_2": "FILLKISH CORRECTIONAL FACILITY BOX #307",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "12527",
            "telephone_number": "845-831-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN-DAVACHI",
        "first_name": "MAHNAZ",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary St John
• State of New York Office of State Comptroller
• Sasha Stim Fogel
• R. J. Storm, MS, L. AC.
• Maria Streva, LMSW
• Arthur Sullivan, PHD
• Lisa Sullivan
• Sun River Health Inc
• Paulina Andrea Taylor, FNP
• Tiffany Demichele Teamer, LCSW

• Family Nurse Practitioner in Beacon, NY
• Providers in Beacon, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.