Provider Demographics
NPI:1174303838
Name:ESTAVILLO, AYLA BEIZ UY (RN)
Entity type:Individual
Prefix:
First Name:AYLA BEIZ
Middle Name:UY
Last Name:ESTAVILLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8675 MIDLAND PKWY APT 3F
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3035
Mailing Address - Country:US
Mailing Address - Phone:917-592-5726
Mailing Address - Fax:
Practice Address - Street 1:8675 MIDLAND PKWY APT 3F
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3035
Practice Address - Country:US
Practice Address - Phone:917-592-5726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY82661201163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse