MEDICARE: DR. DAVID P AVELLA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	MA58666	NJ
2	207L00000X	Anesthesiology Physician	25MA05866600	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134127111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID P AVELLA MD

Provider Business Mailing Address
First Line	:	102 E CENTRE BLVD
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-4129
Country	:	US
Telephone Number	:	856-988-6260
Fax Number	:	856-988-6270

Provider Business Practice Location Address
First Line	:	100 BOWMAN DR FL 2
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-9612
Country	:	US
Telephone Number	:	856-988-6260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	02/22/2024

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