Provider Demographics
NPI:1114141678
Name:PELAVIN, PAUL ISAAC (MS, MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ISAAC
Last Name:PELAVIN
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Gender:M
Credentials:MS, MD
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Mailing Address - Street 1:140 E RIDGEWOOD AVE STE 480N
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3917
Mailing Address - Country:US
Mailing Address - Phone:201-447-8182
Mailing Address - Fax:201-523-9635
Practice Address - Street 1:140 E RIDGEWOOD AVE STE 480N
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3917
Practice Address - Country:US
Practice Address - Phone:201-447-8182
Practice Address - Fax:201-523-9635
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2022-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA084189002080P0205X
NY2323322080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology