Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 046692 | NY |
NPI | 1104969575 |
---|---|
Provider Name | Dr. Karen Francisco Avila |
First Address | Briarcliff Manor, NY 10510-2096 |
Second Address | Briarcliff Manor, NY 10510-2096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 28/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02162696 | (05) | NY |
U86223 | (02) | NY |