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JACKSON, AVILA TYRELL

Debarred entity

JACKSON, AVILA TYRELL is an entity of interest. It has not been found on international sanctions lists.

Type	Legal entity				[sources]
Name	JACKSON, AVILA TYRELL				[sources]
Legal form	not available				[sources]
Country	United States				[sources]
NPI	`1811196488`				[sources]
Sector	PODIATRIST				[sources]
Status	not available				[sources]
Address	100 PHILLIPS ROAD, APT 62, SOMERSET, NJ 08873				[sources]
Last change	2025-09-15	Last processed	2025-11-15	First seen	2025-09-15

Relationships

Sanctions
Country	Authority	Program	Start date	End date
United States	New Jersey Office of the State Comptroller		2020-07-18	-

Address
Full address	Country
100 PHILLIPS ROAD, APT 62, SOMERSET, NJ 08873	United States

Data sources

US New Jersey Ineligible Medicaid Providers7,267

Medical providers disqualified from participating in New Jersey State's Medicaid program.

United States · OIFP

Source data IDs: us-medny-51f71f425445993e1de6b6940deab4ce288d3407 · us-mednj-567704dceed1b4411188dc580786e11470cb764e · us-mednj-457b0d072ae1509d3feddef9ea42613bdaea96cc · us-fed-excl-avia-tyrell-jackson-08873-somerset · us-mednj-9932757a195c07ce09bcadc2a8125f25027de133

For experts: raw data explorer

Factsheet Data sources

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