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General NPI Number Information
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NPI Number | 1700764644
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Entity Type | Individual
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Provider Name | MR. AVARON THOMPSON
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Gender | Male
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 23611 CHAGRIN BLVD
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City | BEACHWOOD
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State | OH
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Zip | 44122-5540
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Country | US
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Telephone | 888-442-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 71 HALLEY DR
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City | POMONA
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State | NY
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Zip | 10970-2108
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Country | US
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Telephone | 718-213-3530
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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