Dr. Jeff Richard Pavell, DO
Physical Medicine & Rehabilitation in Bardonia, NY. Individual provider (NPI-1).
NPI number1790769487
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1790769487
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jeff Richard Pavell
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 6, 2005
- Last updated
- Mar 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | MB69881 | NJ | Yes |
| 208100000X | Physical Medicine & Rehabilitation | 202584 | NY |
Practice location
365 Route 304Ste 102
Bardonia, NY 10954-1601
Phone 845-624-2182 · Fax 845-624-2188
Mailing address
500 Grand AveEnglewood, NJ 07631-4967
Phone 201-567-2277 · Fax 201-567-7506
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