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General NPI Number Information
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NPI Number | 1730424284
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Entity Type | Individual
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Provider Name | CECILIA ELIZABETH AVILA PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 2133 31ST ST
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City | ASTORIA
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State | NY
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Zip | 11105-2601
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Country | US
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Telephone | 929-457-7650
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Fax |
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Provider Business Mailing Address
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Address Line | 2446 79TH ST APT 2
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1565
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Country | US
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Telephone | 718-316-2018
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Fax | 718-446-5939
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 016298
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License Number State | NY
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