Organization
H AVELLA PMR MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD AVELLA MD (OWNER)
(631) 846-4044
Entity
Organization
Contact information
Practice address
1766 SUNRISE HWY, BAY SHORE, NY 11706-6042
(631) 666-4600
(631) 666-4605
Mailing address
PO BOX 707, SELDEN, NY 11784-0674
(631) 846-4044
(631) 846-4044
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
06/30/2010
Last updated
06/30/2010
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