Jeffrey Louis Avery, PAC, MPAS
Physician Assistant in Vestal, NY. Individual provider (NPI-1).
NPI number1508835992
StatusActive
Last updated in NPPESDec 9, 2019
Details
- NPI
- 1508835992
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jeffrey Louis Avery
- Credential
- PAC, MPAS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 16, 2006
- Certification date
- Dec 9, 2019
- Last updated
- Dec 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 007379-1 | NY | Yes |
| 363A00000X | Physician Assistant | MA003068L | PA |
Practice location
4433 Vestal Pkwy EVestal, NY 13850-3556
Phone 607-771-2220 · Fax 607-251-2635
Mailing address
33 Lewis Rd Ste 2Binghamton, NY 13905-1040
Phone 607-729-8156 · Fax 607-729-3982
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All 33 Physician Assistant providers in Vestal · All 740 providers in Vestal
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