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General NPI Number Information
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NPI Number | 1639515596
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Entity Type | Individual
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Provider Name | AVINASH D'SOUZA D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1111 AMSTERDAM AVE
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City | NEW YORK
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State | NY
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Zip | 10025-1716
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Country | US
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Telephone | 212-523-3975
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Fax |
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Provider Business Mailing Address
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Address Line | 4317 MARATHON PKWY
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City | LITTLE NECK
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State | NY
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Zip | 11363-1936
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Country | US
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Telephone | 202-321-1446
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MB10373800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 329064
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License Number State | NY
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