Doctor Name: | MARSON T DAVIDSON |
NPI Number: | 1699708412 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 25MA07449200 |
Business Practice Address: | 30 Prospect Ave Main Building Rm 5640 Hackensack, NJ - 076011914 |
Business Phone Number: | 2019964218 |
Business Fax Number: | 2019964833 |
Mailing Address: | 30 Prospect Ave, Main Building Rm 5640 HACKENSACK |
State: | NJ |
Postal Code: | 076011914 |
Phone Number: | 2019964218 |
Fax Number: | 2019964833 |
NPI Enumeration Date: | 07/07/2006 |
NPI Last Update Date: | 11/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 25MA07449200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |