| Alex R Pavon Md Pc | |
|
106 W Palisade Ave Suite 101 Englewood NJ 07631-2633 | |
| (201) 503-1000 | |
| (201) 568-4300 |
| Full Name | Alex R Pavon Md Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 106 W Palisade Ave, Englewood, New Jersey |
| Authorized Official Name and Position | Alex Rodrigo Pavon (OWNER) |
| Authorized Official Contact | 2015031000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alex R Pavon Md Pc Po Box 5917 Englewood NJ 07631-5917 Ph: (201) 568-6200 | Alex R Pavon Md Pc 106 W Palisade Ave Suite 101 Englewood NJ 07631-2633 Ph: (201) 503-1000 |
| NPI Number | 1407028657 |
|---|---|
| Provider Enumeration Date | 03/27/2008 |
| Last Update Date | 04/07/2008 |
| Medicare PECOS PAC ID | 9537175963 |
|---|---|
| Medicare Enrollment ID | O20091019000565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407028657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 25MA07135200 (New Jersey) | Primary |
| Provider Name | Alex Pavon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700819208 PECOS PAC ID: 3072562107 Enrollment ID: I20050804000724 |
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