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Canonical ID: NK-2EdU7VJhN3TzxUmUvJjSTr · Entity type: LegalEntity (reference)
| Property | Value | Lang | Source dataset | Source ID | First seen | ||
|---|---|---|---|---|---|---|---|
LegalEntity:address | 100 PHILLIPS ROAD, APT 62, SOMERSET, NJ 08873 | eng | us_nj_med_exclusions | us-mednj-457b0d072ae1509d3feddef9ea42613bdaea96cc | |||
Person:address | 86-41 LEFFERTS BLVD, RICHMOND HILL, NY 11418 | ext_us_cms_npi | us-npi-1811196488 | ||||
Person:address | 86-41 LEFFERTS BLVD., RICHMOND HILL, NY 11418 | ext_us_cms_npi | us-npi-1811196488 | ||||
LegalEntity:addressEntity | addr-8d29d81405a6d4b62528e1097092da3bd49f2fab | us_nj_med_exclusions | us-mednj-457b0d072ae1509d3feddef9ea42613bdaea96cc | ||||
Person:country | us | ext_us_cms_npi | us-npi-1811196488 | ||||
LegalEntity:country | us | us_nj_med_exclusions | us-mednj-457b0d072ae1509d3feddef9ea42613bdaea96cc | ||||
Person:firstName | AVILA | ext_us_cms_npi | us-npi-1811196488 | ||||
LegalEntity:id | 581fd7e8a3e588a06ab4729fd6bdb29f488faf9c | us_nj_med_exclusions | us-mednj-457b0d072ae1509d3feddef9ea42613bdaea96cc | ||||
Person:id | f41fd267fa457a4473fc5a7a815cb173861ec602 | ext_us_cms_npi | us-npi-1811196488 | ||||
Person:lastName | JACKSON | ext_us_cms_npi | us-npi-1811196488 | ||||
Person:middleName | T | ext_us_cms_npi | us-npi-1811196488 | ||||
Person:name | AVILA T JACKSON | ext_us_cms_npi | us-npi-1811196488 | ||||
LegalEntity:name | JACKSON, AVILA TYRELL | eng | us_nj_med_exclusions | us-mednj-457b0d072ae1509d3feddef9ea42613bdaea96cc | |||
LegalEntity:npiCode | 1811196488 | eng | us_nj_med_exclusions | us-mednj-457b0d072ae1509d3feddef9ea42613bdaea96cc | |||
Person:npiCode | 1811196488 | ext_us_cms_npi | us-npi-1811196488 | ||||
LegalEntity:sector | PODIATRIST | eng | us_nj_med_exclusions | us-mednj-457b0d072ae1509d3feddef9ea42613bdaea96cc | |||
LegalEntity:topics | debarment | us_nj_med_exclusions | us-mednj-457b0d072ae1509d3feddef9ea42613bdaea96cc | ||||