Provider Demographics
NPI:1538165584
Name:DAVIS, STEVEN R (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:825 E GATE BLVD
Mailing Address - Street 2:STE 111
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2136
Mailing Address - Country:US
Mailing Address - Phone:516-804-5200
Mailing Address - Fax:516-240-6540
Practice Address - Street 1:155 W MERRICK RD
Practice Address - Street 2:STE 102
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3743
Practice Address - Country:US
Practice Address - Phone:516-379-3062
Practice Address - Fax:516-379-4680
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2019-09-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY145626207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00790914Medicaid
00D001OtherBLUE CROSS BLUE SHIELD
145626SOtherHEALTHCARE PARTNERS, IPA
AS064OtherOXFORD HEALTH PLANS
0030298OtherGHI
NY00790914Medicaid
27260POtherHIP HEALTH PLAN OF NY
90318OtherAETNA, INC.
27260POtherHIP HEALTH PLAN OF NY
NY00D001Medicare ID - Type Unspecified