| Matthew H Davis Lcsw, Pllc | |
|
90 Sylvan Pkwy Buffalo NY 14228-1109 | |
| (716) 202-8877 | |
| (716) 463-2226 |
| Full Name | Matthew H Davis Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 90 Sylvan Pkwy, Buffalo, New York |
| Authorized Official Name and Position | Matthew H Davis (OWNER) |
| Authorized Official Contact | 7162028877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew H Davis Lcsw, Pllc 90 Sylvan Pkwy Buffalo NY 14228-1109 Ph: (716) 202-8877 | Matthew H Davis Lcsw, Pllc 90 Sylvan Pkwy Buffalo NY 14228-1109 Ph: (716) 202-8877 |
| NPI Number | 1700404621 |
|---|---|
| Provider Enumeration Date | 07/07/2020 |
| Last Update Date | 07/07/2020 |
| Certification Date | 07/07/2020 |
| Medicare PECOS PAC ID | 9335566595 |
|---|---|
| Medicare Enrollment ID | O20200902001433 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700404621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Matthew H Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609952712 PECOS PAC ID: 7416127378 Enrollment ID: I20110901000074 |
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