Individual
DR. AVASA NALINI JAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
11512 LIBERTY AVE STE 2B, JAMAICA, NY 11419-1902
(929) 499-3287
Mailing address
2838 STILLWELL AVE APT 3B, BROOKLYN, NY 11224-2685
(347) 320-1770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
060613
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/11/2019
Last updated
08/21/2019
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