Jackson, Avila T

Jackson, Avila T is an individual health care provider with primary practice located at 86-41 Lefferts Blvd. , Richmond Hill NY 11418. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, which is considered as his primary health care specialty. Jackson, Avila T can be contacted via phone (718) 849-3338.

Contact Information

Primary practice address
86-41 Lefferts Blvd. Richmond Hill NY 11418
Phone: (718) 849-3338
Fax: (718) 849-3166
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 5901002248 Michigan
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 006459 New York

Profile Details

NPI number 1811196488
LBN Legal business name Jackson, Avila T
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2007
Last updated May 31st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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