Provider Demographics
NPI:1548401573
Name:AVILA, ELI NARCISO (MD, JD, MPH)
Entity type:Individual
Prefix:DR
First Name:ELI
Middle Name:NARCISO
Last Name:AVILA
Suffix:
Gender:M
Credentials:MD, JD, MPH
Other - Prefix:
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Mailing Address - Street 1:1 BUFFINGTON ST BLDG 40-4
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:NY
Mailing Address - Zip Code:12189-4050
Mailing Address - Country:US
Mailing Address - Phone:518-266-4195
Mailing Address - Fax:518-266-4547
Practice Address - Street 1:1 BUFFINGTON ST BLDG 40-4
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:NY
Practice Address - Zip Code:12189-4050
Practice Address - Country:US
Practice Address - Phone:518-266-4195
Practice Address - Fax:518-266-4547
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-21
Last Update Date:2024-07-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY171294209800000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No209800000XAllopathic & Osteopathic PhysiciansLegal Medicine