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General NPI Number Information
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NPI Number | 1548401573
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Entity Type | Individual
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Provider Name | ELI NARCISO AVILA MD, JD, MPH
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Gender | Male
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Dates
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Enumeration Date | 03/21/2009
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1 BUFFINGTON ST BLDG 40-4
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City | WATERVLIET
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State | NY
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Zip | 12189-4050
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Country | US
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Telephone | 518-266-4195
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Fax | 518-266-4547
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Provider Business Mailing Address
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Address Line | 1 BUFFINGTON ST BLDG 40-4
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City | WATERVLIET
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State | NY
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Zip | 12189-4050
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Country | US
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Telephone | 518-266-4195
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Fax | 518-266-4547
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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 | 209800000X
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Taxonomy Name | Legal Medicine (M.D./D.O.) Physician
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License Number | 171294
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 171294
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License Number State | NY
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