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General NPI Number Information
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NPI Number | 1669475083
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Entity Type | Individual
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Provider Name | PAUL KOVATIS MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 784 FRANKLIN AVE
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City | FRANKLIN LAKES
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State | NJ
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Zip | 07417-1306
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Country | US
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Telephone | 844-777-0910
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Fax |
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Provider Business Mailing Address
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Address Line | 784 FRANKLIN AVE
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City | FRANKLIN LAKES
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State | NJ
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Zip | 07417-1306
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Country | US
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Telephone | 844-777-0910
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Fax | 201-560-0712
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA05561000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 25MA05561000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 25MA05561000
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License Number State | NJ
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