Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 25MA05561000 | NJ |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 25MA05561000 | NJ |
NPI | 1669475083 |
---|---|
Provider Name | Dr. Paul Kovatis |
First Address | Franklin Lakes, NJ 07417-1306 |
Second Address | Franklin Lakes, NJ 07417-1306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 02/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0817957 | AETNA HMO # (01) | NJ |
200027488 | RR MDCR # (01) | NJ |
512961 | EMPIRE BC/BS # (01) | NJ |
5986397 | AETNA PPO # (01) | NJ |
G32796 | (02) | NJ |
P409968 | OXFORD # (01) | NJ |