Provider Demographics
NPI:1073508198
Name:PAVLAKIS, STEVEN G (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:PAVLAKIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:977 48TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2919
Mailing Address - Country:US
Mailing Address - Phone:718-283-8015
Mailing Address - Fax:718-635-7235
Practice Address - Street 1:948 48TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2918
Practice Address - Country:US
Practice Address - Phone:718-283-8260
Practice Address - Fax:718-635-7235
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1513332080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2661329OtherAETNA USHC HMO
NY151333OtherHEALTH FIRST
NY00872371Medicaid
NY4C0890OtherHEALTH NET
NY9E2931OtherEMPIRE BCBS
NYP2532131OtherOXFORD HEALTH PLAN
NY1000004624OtherAFFINITY HEALTH
NY0066775OtherGHI
NYPS1333OtherATLANTIS HEALTH
NY108053 15OtherUNITED HEALTH CARE
NY4312673OtherAETNA PPO
NYPS1333OtherATLANTIS HEALTH
NY00872371Medicaid