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General NPI Number Information
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NPI Number | 1356651319
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Entity Type | Organization
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Legal Business Name | JAVAD KHAVARIAN MD PA
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 733 N BEERS ST SUITE L3
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City | HOLMDEL
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State | NJ
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Zip | 07733-1528
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Country | US
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Telephone | 732-739-3130
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Fax | 732-739-1783
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Provider Business Mailing Address
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Address Line | 733 N BEERS ST SUITE L3
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City | HOLMDEL
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State | NJ
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Zip | 07733-1528
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Country | US
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Telephone | 732-739-3130
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Fax | 732-739-1783
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Authorized Official
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Title or Position | ORTHOPAEDIC SURGEON
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Name | DR. JAVAD KHAVARIAN
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Credential | M.D.
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Telephone | 732-739-3130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA02527500
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License Number State | NJ
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