Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 25MA05427500 | NJ |
NPI | 1023014909 |
---|---|
Provider Name | Dr. George Pavlou |
First Address | Woodland Park, NJ 07424-3806 |
Second Address | Woodland Park, NJ 07424-2610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 27/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0415017 | GHI PPO (01) | NJ |
0507703000 | AMERIHEALTH (01) | NJ |
110076087 | RAILROAD MEDICARE (01) | NJ |
1945337 | AETNA HMO (01) | NJ |
3K8624 | HEALTHNET (01) | NJ |
4298741 | AETNA PPO (01) | NJ |
439953 | WELLCARE (01) | NJ |
5395305 | (05) | NJ |
830AM1 | EMPIRE BC/BS (01) | NJ |
830AM2 | EMPIRE BC/BS (01) | NJ |
E87157 | (02) | NJ |
P3929711 | OXFORD (01) | NJ |