Provider Demographics
NPI:1194814905
Name:SCAVRON, JEFFREY NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:NEIL
Last Name:SCAVRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1181 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5018
Mailing Address - Country:US
Mailing Address - Phone:516-931-2320
Mailing Address - Fax:516-931-5734
Practice Address - Street 1:1181 OLD COUNTRY RD
Practice Address - Street 2:SUITE 3
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-5018
Practice Address - Country:US
Practice Address - Phone:516-931-2320
Practice Address - Fax:516-931-5734
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY144151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12D181Medicare ID - Type Unspecified
NYF10385Medicare UPIN