Organization
AVILLA INC
Active
Other names
AVILLA INC
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS AVILLA MSPT (PRESIDENT/CEO/OWNER)
(516) 384-1206
Entity
Organization
Contact information
Practice address
5 CAMDEN CT, MEDFORD, NY 11763-1583
(516) 384-1206
(631) 736-4334
Mailing address
5 CAMDEN CT, MEDFORD, NY 11763-1583
(516) 384-1206
(631) 736-4334
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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