Individual
DR. JACQUELINE AVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3170 BROADWAY, GRANT HOUSES HEALTH CENTER, NEW YORK, NY 10027-3341
(212) 678-8420
(212) 678-8461
Mailing address
1068 ROXBURY DR, WESTBURY, NY 11590-5422
(516) 333-9313
(212) 678-8461
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
157314
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01117835
—
NY
Enumeration date
07/19/2006
Last updated
07/08/2007
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