Individual provider Active NPI

Ednal Humberto Avalos, LPN

  • Licensed Practical Nurse
  • Perth Amboy, NJ
National Provider Identifier
1841069358
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
26NP49525700 Issued in NJ
Practice address
360 Neville St
Perth Amboy, NJ 08861-3346
Phone
(732) 277-1907
NPI assigned
Dec 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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 26NP49525700 NJ Primary

Addresses

Primary practice location

360 Neville St
Perth Amboy, NJ 08861-3346

Mailing address

360 Neville St
Perth Amboy, NJ 08861-3346
Phone (732) 277-1907

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
26NP49525700NJMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1841069358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 NEVILLE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613346",
            "telephone_number": "732-277-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 NEVILLE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613346",
            "telephone_number": "732-277-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVALOS",
        "first_name": "EDNAL",
        "middle_name": "HUMBERTO",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-26",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NJ",
            "license": "26NP49525700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.