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
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Gender:M
Credentials:MD, JD, MPH
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Mailing Address - Street 1:USA MEDDAC
Mailing Address - Street 2:11050 MOUNT BELVEDERE BLVD
Mailing Address - City:FORT DRUM
Mailing Address - State:NY
Mailing Address - Zip Code:13602
Mailing Address - Country:US
Mailing Address - Phone:518-266-4195
Mailing Address - Fax:518-266-4547
Practice Address - Street 1:124 MAIN ST
Practice Address - Street 2:OFFICE OF COMMISSIONER OF HEALTH
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2124
Practice Address - Country:US
Practice Address - Phone:845-360-6603
Practice Address - Fax:845-291-2341
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-21
Last Update Date:2021-12-20
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Provider Licenses
StateLicense IDTaxonomies
NY1712942083X0100X, 209800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No209800000XAllopathic & Osteopathic PhysiciansLegal Medicine