Avella, Douglas George

Avella, Douglas George is an individual health care provider with primary practice located at 140 Chestnut St Suite 201, Ridgewood NJ 07450-2599. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery, which is considered as his primary health care specialty. Avella, Douglas George can be contacted via phone (201) 612-9988.

Contact Information

Primary practice address
140 Chestnut St Suite 201 Ridgewood NJ 07450-2599
Phone: (201) 612-9988
Fax: (201) 445-9050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery 207XP3100X 25MA03908700 New Jersey

Profile Details

NPI number 1437200672
LBN Legal business name Avella, Douglas George
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2007
Last updated Jan 20th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437200672 NPPES
New Jersey Other 81042 AMERIGROUP
New Jersey Other BS472 AMERIGROUP
New Jersey Other 0961576-004 AMERIGROUP
New Jersey MEDICAID 1822900 AMERIGROUP
New Jersey Other J31130 AMERIGROUP
New Jersey Other 81D03 AMERIGROUP

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