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Organization
AVALON MEDICAL GROUP LLC
Active
Organization
AVALON MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR KOSTANIAN (MEMBER/OWNER)
(718) 838-0640
Entity
Organization
Contact information
Practice address
1135 CLIFTON AVE STE 209, CLIFTON, NJ 07013-3642
(862) 336-9696
Mailing address
1135 CLIFTON AVE STE 209, CLIFTON, NJ 07013-3642
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
246XC2903X
Vascular Specialist/Technologist Cardiovascular
—
NULL
246XC2903X
Vascular Specialist/Technologist Cardiovascular
—
—
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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