Organization
AVANAVA PC
Active
Organization
AVANAVA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYA R THERATTIL (DIRECTOR)
(609) 216-9422
Entity
Organization
Contact information
Practice address
2381 LAWRENCEVILLE RD, ST.LAWRENCE REHABILITATION CENTER, DOCTORS OFFICES, LAWRENCEVILLE, NJ 08648-2025
(609) 896-8152
(609) 896-4107
Mailing address
71 WESTBURY CT, SKILLMAN, NJ 08558-1726
(609) 216-9422
(609) 896-4107
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MA07576900
NJ
Other
Enumeration date
11/19/2014
Last updated
11/19/2014
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