Jaclyn Avenilov

NPI 1063764470 - Specialist - 174400000X

NPI Details
NPI 1063764470
Gender Female
Enumeration Date 10/09/2012
Last Updated 10/09/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
2843 BRAGG ST
BROOKLYN NY, 11235-1101, US
Phone (718) 362-0908
Fax
Business Location
2843 BRAGG ST
BROOKLYN NY, 11235-1101, US
Phone (718) 362-0908
Fax
Toxanomy
Taxonomy Code 174400000X
License State New York
License Number 608851121
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According to our database, Ms. Jaclyn Avenilov NPI is 1063764470, taxonomy code is 174400000X and license number is 608851121, license state is located at New York. Jaclyn Avenilov physically located at 2843 Bragg St, Brooklyn NY, 11235-1101. NPI Number Jaclyn Avenilov has the Individual type.

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1063764470 NPI number is provided on an as is basis without warranty of any kind. 1063764470 is maintained by the National Plan & Provider Enumeration System. The contents of Jaclyn Avenilov are for informational purposes only.