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NPI Code Detail

MEDICARE: JAY PANCHAL M.D.

MEDICARE: JAY PANCHAL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician25MA10763600NJ

General Provider Information

NPI Number : 1306232798
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY PANCHAL M.D.
Provider Business Mailing Address
First Line : 910 SYLVAN AVE STE 100
Second Line :
City : ENGLEWOOD CLIFFS
State : NJ
Zip : 07632-3308
Country : US
Telephone Number : 201-569-2770
Fax Number : 201-569-1774
Provider Business Practice Location Address
First Line : 910 SYLVAN AVE STE 100
Second Line :
City : ENGLEWOOD CLIFFS
State : NJ
Zip : 07632-3308
Country : US
Telephone Number : 201-569-2770
Fax Number : 201-569-1774
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2015
Last Update Date : 06/23/2023

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