Organization
AVALON MEDICAL CENTER, LLC
Active
Organization
AVALON MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR KOSTANIAN (MEMBER)
(718) 838-0640
Entity
Organization
Contact information
Practice address
121 EXECUTIVE DR STE 200, NEW WINDSOR, NY 12553-5544
(845) 407-0770
Mailing address
121 EXECUTIVE DR STE 200, NEW WINDSOR, NY 12553-5544
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
213E00000X
Podiatrist
—
—
225100000X
Physical Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
06/21/2023
Last updated
06/22/2023
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