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NPI Code Detail

MEDICARE: MS. INGRID AVILES APRN

MEDICARE: MS. INGRID AVILES APRN
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
1363L00000XNurse Practitioner26NJ15492000NJ

General Provider Information

NPI Number : 1790640977
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. INGRID AVILES APRN
Provider Business Mailing Address
First Line : 180 COLUMBIA AVE
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07307-4019
Country : US
Telephone Number : 201-320-7271
Fax Number :
Provider Business Practice Location Address
First Line : 201 LYONS AVE
Second Line :
City : NEWARK
State : NJ
Zip : 07112-2027
Country : US
Telephone Number : 973-926-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/20/2025

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