Individual
DR. GEORGE JEFFREY GAVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
NVRA BUSINESS OFFICE, 385 MAIN ST SOUTH, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Mailing address
NVRA BUSINESS OFFICE, 385 MAIN ST SOUTH, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
054089
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D400227511
MRI
CT
01
—
D400227516
DIS
CT
01
—
D400227517
DIA
CT
01
—
D400227521
NVRA
CT
01
—
D400227523
PDI
CT
Enumeration date
06/05/2010
Last updated
07/13/2021
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