MEDICARE: LINDSAY AVERILL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	022005	NY

General Provider Information

NPI Number	:	1134503931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY AVERILL

Provider Business Mailing Address
First Line	:	319 N. MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PELHAM PKWY S STE 1213
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461
Country	:	US
Telephone Number	:	718-918-5590
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2015
Last Update Date	:	03/14/2025

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Directions to “ LINDSAY AVERILL ” Practice Location

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