| Dr Krysten L Avery, OD | |
|
1979 Marcus Ave Ste 206, North New Hyde Park, NY 11042-1002 | |
| (877) 506-0002 | |
| Not Available |
| Full Name | Dr Krysten L Avery |
|---|---|
| Gender | Female |
| Speciality | Optometrist |
| Location | 1979 Marcus Ave Ste 206, North New Hyde Park, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770670697 | NPI | - | NPPES |
| 1770670697 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | TPOP10 (Florida) | Secondary |
| 152W00000X | Optometrist | 4901004395 (Michigan) | Primary |
| Provider Name | Southwest Vision Center Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1871852939 PECOS PAC ID: 8426209107 Enrollment ID: O20121105000554 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Krysten L Avery, OD 8256 Nadell St, Delton, MI 49046-8202 Ph: (269) 267-7902 | Dr Krysten L Avery, OD 1979 Marcus Ave Ste 206, North New Hyde Park, NY 11042-1002 Ph: (877) 506-0002 |
Paola Jelena Burburan, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1981 Marcus Ave Ste E115, North New Hyde Park, NY 11042 Phone: 516-627-5113 | |
William Bercha, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1979 Marcus Ave, North New Hyde Park, NY 11042 Phone: 888-506-0002 | |
Dr. Lisa P. Nguyen, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 5 Dakota Dr Ste 307, North New Hyde Park, NY 11042 Phone: 408-518-2628 |