Healthcare Provider Details

I. General information

NPI: 1497784037
Provider Name (Legal Business Name): DAVID AVINO, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3671 SOUTHWESTERN BLVD SUITE 107
ORCHARD PARK NY
14127-1752
US

IV. Provider business mailing address

908 NIAGARA FALLS BLVD SUITE 208
NORTH TONAWANDA NY
14120-2019
US

V. Phone/Fax

Practice location:
  • Phone: 716-667-2062
  • Fax: 716-667-2063
Mailing address:
  • Phone: 716-692-3302
  • Fax: 716-692-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID AVINO
Title or Position: OWNER
Credential: MD
Phone: 716-667-2062