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General NPI Number Information
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NPI Number | 1548552367
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Entity Type | Organization
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Legal Business Name | ISRAEL AVILES MD PC
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 9001A ROOSEVELT AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7938
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Country | US
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Telephone | 718-396-2005
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Fax | 718-396-2006
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Provider Business Mailing Address
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Address Line | 9001A ROOSEVELT AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7938
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Country | US
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Telephone | 718-396-2005
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Fax | 718-396-2006
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ISRAEL A AVILES
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Credential | MD
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Telephone | 718-396-2005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number |
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License Number State |
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