# AVALON MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851123004
- **Authorized official:** ARTHUR KOSTANIAN (MEMBER/OWNER)
- **Authorized official phone:** (718) 838-0640

## Contact information

- **Practice address:** 1135 CLIFTON AVE STE 209, CLIFTON, NJ 07013-3642
- **Practice address phone:** (862) 336-9696
- **Mailing address:** 1135 CLIFTON AVE STE 209, CLIFTON, NJ 07013-3642

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 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