Individual
BERNADETTE AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
49 LAWRENCE AVE, POTSDAM, NY 13676-1889
(315) 261-5550
Mailing address
50 LEROY ST, POTSDAM, NY 13676-1786
(153) 261-3300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
027698
NY
Other
Enumeration date
09/19/2020
Last updated
07/10/2024
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