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NPI Code Detail

MEDICARE: THOMAS J AVELLA M.D.

MEDICARE:   THOMAS J AVELLA  M.D.
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 Physician232972NY

General Provider Information

NPI Number : 1932105541
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS J AVELLA M.D.
Provider Business Mailing Address
First Line : 155 CRYSTAL RUN RD
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10941-4028
Country : US
Telephone Number : 845-703-6999
Fax Number : 845-703-6297
Provider Business Practice Location Address
First Line : 6 LIBERTY SQUARE MALL
Second Line :
City : STONY POINT
State : NY
Zip : 10980-2400
Country : US
Telephone Number : 845-786-5544
Fax Number : 845-987-5979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/31/2020

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Directions to “ THOMAS J AVELLA M.D.” Practice Location

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