JACKIE S AVERY DPM NPI 1134225063

NPI Information

Jackie S Avery, DPM is a foot surgery podiatrist in Queensbury, NY with 25 years of experience. Jackie S Avery, DPM NPI is 1134225063. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
Graduation Year:1999

The provider's business location address is:

161 CAREY RD
QUEENSBURY, NY
ZIP 12804-821
Phone: (518) 824-8610
Fax: (518) 824-2390

The NPI 1134225063 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 9/16/2006 and was last updated on 11/30/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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