Individual provider Active NPI

Betty Avtzon, LPN

  • Licensed Practical Nurse
  • Spring Valley, NY
National Provider Identifier
1184034472
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
290305-1 Issued in NY
Practice address
472 Viola Rd
Spring Valley, NY 10977-2539
Phone
(845) 354-5657
NPI assigned
May 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 290305-1 NY Primary

Addresses

Primary practice location

472 Viola Rd
Spring Valley, NY 10977-2539

Mailing address

472 Viola Rd
Spring Valley, NY 10977-2539
Phone (845) 354-5657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
290305-1NYMDSurgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1184034472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 VIOLA RD",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109772539",
            "telephone_number": "845-354-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 VIOLA RD",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109772539",
            "telephone_number": "845-354-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVTZON",
        "first_name": "BETTY",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "290305-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.