Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 25MA08418900 | NJ |
NPI | 1114141678 |
---|---|
Provider Name | Dr. Paul Isaac Pelavin |
First Address | Paramus, NJ 07652-3917 |
Second Address | Paramus, NJ 07652-3917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 10/02/2022 |