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General NPI Number Information
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NPI Number | 1629362488
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Entity Type | Organization
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Legal Business Name | AVANY MEDICAL PC
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Dates
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Enumeration Date | 06/08/2011
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 2350 OCEAN AVE SUITE 8
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City | BROOKLYN
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State | NY
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Zip | 11229-3030
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Country | US
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Telephone | 718-787-0100
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Fax | 347-824-2288
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Provider Business Mailing Address
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Address Line | 4626 BEDFORD AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-2612
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Country | US
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Telephone | 917-640-4641
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LUCIA V AVANY
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Credential | M.D.
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Telephone | 917-640-4641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 255008
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License Number State | NY
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