Provider Demographics
NPI:1144984840
Name:DAVIS, ALLISON KAY
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:KAY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 DICKERSON LN
Mailing Address - Street 2:
Mailing Address - City:GILLETT
Mailing Address - State:PA
Mailing Address - Zip Code:16925-9169
Mailing Address - Country:US
Mailing Address - Phone:607-259-9358
Mailing Address - Fax:
Practice Address - Street 1:169 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4246
Practice Address - Country:US
Practice Address - Phone:607-798-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program