Provider Demographics
NPI:1891125977
Name:AVILES, MIGUEL (MHS-CC)
Entity Type:Individual
Prefix:MR
First Name:MIGUEL
Middle Name:
Last Name:AVILES
Suffix:
Gender:M
Credentials:MHS-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10744 90TH ST
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-1426
Mailing Address - Country:US
Mailing Address - Phone:347-489-4572
Mailing Address - Fax:
Practice Address - Street 1:10744 90TH ST
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-1426
Practice Address - Country:US
Practice Address - Phone:347-489-4572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health