Individual
DR. VINCENT STEVEN AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 OLD COUNTRY RD, SUITE 111, MINEOLA, NY 11501-4198
(516) 745-0500
(516) 745-1534
Mailing address
300 OLD COUNTRY RD, SUITE 111, MINEOLA, NY 11501-4198
(516) 745-0500
(516) 745-1534
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
169989
NY
207RN0300X
Nephrology Physician
Primary
169989
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01835703
—
NY
Enumeration date
07/08/2005
Last updated
12/19/2012
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