Individual
DR. MARTIN DAVID PELAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 OLD TAPPAN ROAD, OLD TAPPAN, NJ 07675
(201) 666-1000
(201) 666-4108
Mailing address
215 OLD TAPPAN ROAD, OLD TAPPAN, NJ 07675
(201) 666-1000
(201) 666-4108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA03311200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010033112NJ01
ANTHEM HEALTH
—
01
—
13336
USHC
—
01
—
1819727
UNITEDHLTHCR
—
01
—
18362
MASTERCARE
—
01
—
221941517
HORIZON BCBS
—
01
—
221941517003
PRUDENTIAL
—
01
—
294071
EMPIRE HLTHCR
—
01
—
4250316
AETNA
—
05
—
4727908
—
NJ
01
—
6445171002
CIGNA
—
01
—
80599
AMERIGROUP
—
01
—
998607
REFERRAL
—
01
—
BP028
OXFORD
—
01
—
F01394
HEALTHNET
—
Enumeration date
08/18/2006
Last updated
11/17/2009
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