Healthcare Provider Details

I. General information

NPI: 1689664773
Provider Name (Legal Business Name): JAYNE PAVLAK-SCHENK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 ROUTE 88 W SUITE 250
BRICK NJ
08724-3009
US

IV. Provider business mailing address

1608 ROUTE 88 W SUITE 250
BRICK NJ
08724-3009
US

V. Phone/Fax

Practice location:
  • Phone: 732-840-8880
  • Fax: 732-840-3939
Mailing address:
  • Phone: 732-840-8880
  • Fax: 732-840-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25MB04677600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: