Individual
MICHELLE A IAVICOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1103 KINGS HWY N, SUITE 201, CHERRY HILL, NJ 08034-1983
(856) 321-1800
(856) 321-0133
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MA58121
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010003803
AMERICHOICE
NJ
01
—
0809776000
AMERIHEALTH/KEYSTONE/IBC
NJ
01
—
1078883
HORIZON NJ HEALTH
NJ
01
—
1163594
HORIZON NJ HEALTH
NJ
01
—
160055209
RR MEDICARE
NJ
01
—
2051479
AETNA
NJ
01
—
2067761
UNITED HEALTHCARE
NJ
01
—
2207020
AETNA
NJ
01
—
24630
UNIVERSITY HEALTH PLAN
NJ
01
—
2542331
CIGNA
NJ
01
—
3K6126
HEALTHNET
NJ
05
—
7615001
—
NJ
01
—
783367
AMERIHEALTH PPO/PA BS
NJ
01
—
JP131
OXFORD
NJ
Enumeration date
10/04/2006
Last updated
08/30/2019
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