Basic Information
| Provider Information | |||||||||
| NPI: | 1669649968 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AVARBOCK | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | BRIAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 575 LEXINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100226102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6469623376 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 156 WILLIAM ST | ||||||||
| Address2: | 7TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100382609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6469623376 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2008 | ||||||||
| LastUpdateDate: | 10/15/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 257508 | NY | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.