Provider Demographics
NPI:1053654533
Name:PAVELIC, JULIA SHELKEY (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:SHELKEY
Last Name:PAVELIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ALLISON
Other - Last Name:SHELKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:PH5-133 STEM, CUMC DEPT OF ANESTHESIOLOGY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:413-627-9697
Mailing Address - Fax:
Practice Address - Street 1:1 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922
Practice Address - Country:US
Practice Address - Phone:908-277-8872
Practice Address - Fax:908-673-7382
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA10262800207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program