Provider Demographics
NPI:1558553255
Name:AVIA HEALTHCARE P.C.
Entity Type:Organization
Organization Name:AVIA HEALTHCARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BARTASIUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:856-235-0202
Mailing Address - Street 1:3 HOVTECH BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6306
Mailing Address - Country:US
Mailing Address - Phone:856-235-0202
Mailing Address - Fax:856-235-3377
Practice Address - Street 1:501 ROUTE 168
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-1458
Practice Address - Country:US
Practice Address - Phone:856-374-1200
Practice Address - Fax:856-401-3122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00539200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3699221OtherCIGNA
NJ611534200OtherACS
NJ2729618000OtherAMERIHEALTH
NJ3699221OtherCIGNA