Look up the most recent NPI and PECOS records

Dedan Davenport

Social Worker

Behavioral Health & Social Service Providers

19 Greenridge Ave, White Plains, NY 10605-1201

PECOS Enrollment

Based on the most recent information from CMS, provider Dedan Davenport is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1659758274
Provider Type
Individual
Full Name
Davenport, Dedan
Title
Mr.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/4/2015
Last Updated
5/4/2015

Contact Information

Practice Location

19 Greenridge Ave, White Plains, NY 10605-1201

(914) 949-7680

Unlisted Fax

Mailing Location

60 Newtown Rd # 146, Danbury, CT 06810-6257

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer

Dedan Davenport

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Molloy, Margaret G.

Cave, Kathleen Anne

Sturtz, Claudia G

Mcgregor, Ronald

Marshall, Harrison

Kaufman, Susan Gomberg

Farrar, Dawn

Rubel, Helen Judith

Derosa, Lauren

Pierce, Beverly D