Individual
RONALD C. AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 BLOOMFIELD AVE, BLOOMFIELD, NJ 07003-5689
(973) 743-0792
Mailing address
653 RIDGE RD APT D, LYNDHURST, NJ 07071-3241
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00486700
NJ
Other
Enumeration date
01/28/2013
Last updated
01/28/2013
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