Individual
MR. KEVIN SHAILESH AVICHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2317 CENTER ISLAND, ROUTE 22, UNION, NJ 07083
(201) 354-1951
(201) 354-1952
Mailing address
1244 PLANE ST, UNION, NJ 07083-3820
(908) 265-7873
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25MP00445700
NJ
363A00000X
Physician Assistant
021217
NY
363A00000X
Physician Assistant
25MP00445700
NJ
363AM0700X
Medical Physician Assistant
Primary
25MP00445700
NJ
Other
Enumeration date
08/26/2017
Last updated
05/02/2024
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