Provider Demographics
NPI:1235190307
Name:PAWLOWICZ, JAIME J (NP)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:J
Last Name:PAWLOWICZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:J
Other - Last Name:CAPUTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:812 LAKEHURST AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-5246
Mailing Address - Country:US
Mailing Address - Phone:732-928-3063
Mailing Address - Fax:609-586-3161
Practice Address - Street 1:2073 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3414
Practice Address - Country:US
Practice Address - Phone:609-631-7108
Practice Address - Fax:609-586-3161
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00071100363LA2100X
NJ26NO12061100163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q30033Medicare UPIN
NJ085928Medicare PIN