Healthcare Provider Details

I. General information

NPI: 1285793042
Provider Name (Legal Business Name): JEFFREY P KAVALIN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 NORTH AVE E
WESTFIELD NJ
07090-1443
US

IV. Provider business mailing address

425 NORTH AVE E
WESTFIELD NJ
07090-1443
US

V. Phone/Fax

Practice location:
  • Phone: 908-789-3400
  • Fax: 908-654-9286
Mailing address:
  • Phone: 908-789-3400
  • Fax: 908-654-9286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00353600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: