Provider Demographics
NPI:1538320494
Name:AVANY, LUCIA V (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:V
Last Name:AVANY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2612
Mailing Address - Country:US
Mailing Address - Phone:718-787-0100
Mailing Address - Fax:347-824-2288
Practice Address - Street 1:2960 OCEAN AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3202
Practice Address - Country:US
Practice Address - Phone:718-787-0100
Practice Address - Fax:347-824-2288
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255008207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03175293Medicaid
NY03175293Medicaid