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General NPI Number Information
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NPI Number | 1205245982
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Entity Type | Individual
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Provider Name | JAMES B CANAVAN M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 05/23/2020
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Provider Practice Location Address
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Address Line | 3401 PRINCETON PIKE
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-1205
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Country | US
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Telephone | 617-642-1841
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Fax |
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Provider Business Mailing Address
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Address Line | 372 5TH AVE APT 2B
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City | NEW YORK
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State | NY
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Zip | 10018-8107
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Country | US
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Telephone | 617-642-1841
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 281974
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License Number State | NY
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