Individual ProviderLara Mattei DavilaStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice AddressOne Gustave L. Levy Place, Department Of Pediatrics-Bx 1512, New York, NY 10029(212) 241-6937PECOS EnrollmentBased on the most recent information from CMS, provider Lara Mattei Davila does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1235834748Provider TypeIndividualFull NameMattei Davila, LaraCredentialMDGenderFemaleSole ProprietorNoEnumeration Date4/3/2023Last Updated4/3/2023Contact InformationPractice LocationPractice AddressOne Gustave L. Levy Place, Department Of Pediatrics-Bx 1512, New York, NY 10029Phone(212) 241-6937FaxUnlisted FaxMailing LocationMailing AddressOne Gustave L. Levy Place, Department Of Pediatrics - Box 1512, New York, NY 10029-6504Phone(212) 241-6937FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer