Individual
ANDRIY PAVLENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2201 CHAPEL AVE W, CHERRY HILL, NJ 08002-2048
(856) 488-6560
(856) 488-6846
Mailing address
2201 CHAPEL AVE W, CHERRY HILL, NJ 08002-2048
(856) 488-6560
(856) 488-6846
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
244058
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MA08321600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0201529
—
NJ
01
—
P00755920
RAILROAD MEDICARE
NJ
Enumeration date
01/22/2009
Last updated
04/05/2016
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