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General NPI Number Information
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NPI Number | 1275954638
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Entity Type | Individual
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Provider Name | ANITA AVILA AU.D.
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Gender | Female
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Dates
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Enumeration Date | 01/02/2014
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Last Update Date | 01/02/2014
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Provider Practice Location Address
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Address Line | 152 MADISON AVE 1104
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City | NEW YORK
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State | NY
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Zip | 10016-5424
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Country | US
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Telephone | 212-921-1666
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Fax | 636-395-3309
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Provider Business Mailing Address
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Address Line | 2513 86TH ST
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City | EAST ELMHURST
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State | NY
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Zip | 11369-1026
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Country | US
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Telephone | 347-724-0107
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Fax | 646-395-3309
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 002502
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License Number State | NY
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