Individual
AVI TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1111 AMSTERDAM AVE, NEW YORK, NY 10025-1716
(212) 523-5678
(212) 523-3550
Mailing address
270 RIVERSIDE DR APT 10C, NEW YORK, NY 10025-5211
(212) 523-5678
(212) 523-3550
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
000768
NY
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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