Individual
DR. JEFF RICHARD PAVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
365 ROUTE 304, STE 102, BARDONIA, NY 10954-1601
(845) 624-2182
(845) 624-2188
Mailing address
500 GRAND AVE, ENGLEWOOD, NJ 07631-4967
(201) 567-2277
(201) 567-7506
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
202584
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MB69881
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804550
—
NJ
01
—
DO7698000
CDS
NJ
Enumeration date
12/06/2005
Last updated
03/07/2023
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