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NPI Code Detail

MEDICARE: AVANT MEDICAL GROUP LLP

MEDICARE: AVANT MEDICAL GROUP LLP
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1215507819
Entity Type Code : Organization
Provider Name (Legal Business Name) : AVANT MEDICAL GROUP LLP
Provider Business Mailing Address
First Line : 233 BROADWAY RM 2750
Second Line :
City : NEW YORK
State : NY
Zip : 10279-2704
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 233 BROADWAY RM 2750
Second Line :
City : NEW YORK
State : NY
Zip : 10279-2704
Country : US
Telephone Number : 212-245-6893
Fax Number : 212-481-1089
Authorized Official
Title or Position : OWNER
Name : INESSA KHAYKIS
Credential : MD
Telephone Number : 212-245-6893
Provider Enumeration Date : 06/28/2021
Last Update Date : 08/22/2023

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