Avery, Krysten L
Avery, Krysten L is an sole proprietor health care provider with primary practice located at 1979 Marcus Ave Ste 206 , North New Hyde Park NY 11042-1002. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Avery, Krysten L can be contacted via phone (877) 506-0002.Contact Information
Primary practice address
1979 Marcus Ave Ste 206
North New Hyde Park NY 11042-1002
Phone: (877) 506-0002
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TPOP10 | Florida |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901004395 | Michigan |
Profile Details
| NPI number | 1770670697 |
|---|---|
| LBN Legal business name | Avery, Krysten L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Jun 7th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770670697 | NPPES |
| Michigan | MEDICAID | 1770670697 |
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