Individual
DR. KRYSTEN L AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1979 MARCUS AVE STE 206, NORTH NEW HYDE PARK, NY 11042-1002
(877) 506-0002
Mailing address
8256 NADELL ST, DELTON, MI 49046-8202
(269) 267-7902
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004395
MI
152W00000X
Optometrist
TPOP10
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770670697
—
MI
Enumeration date
10/10/2006
Last updated
06/07/2021
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