Individual
DR. DOUGLAS GEORGE AVELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 CHESTNUT ST, SUITE 201, RIDGEWOOD, NJ 07450-2599
(201) 612-9988
(201) 445-9050
Mailing address
140 CHESTNUT ST, SUITE 201, RIDGEWOOD, NJ 07450-2599
(201) 612-9988
(201) 445-9050
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
25MA03908700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0961576-004
CIGNA
NJ
05
—
1822900
—
NJ
01
—
81042
AMERIGROUP
NJ
01
—
81D03
EMPIRE BCBS
NJ
01
—
BS472
OXFORD
NJ
01
—
J31130
HEALTHNET
NJ
Enumeration date
01/15/2007
Last updated
01/20/2012
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