Individual
DR. NICHOLAS ALEXANDER AVITABILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
855 STATE ROUTE 17M, MONROE, NY 10950-1600
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
264177
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03461016
—
NY
Enumeration date
04/18/2010
Last updated
07/31/2020
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