Provider Demographics
NPI:1922574516
Name:GAVEN, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:GAVEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CHURCHILL AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-3501
Mailing Address - Country:US
Mailing Address - Phone:609-558-7837
Mailing Address - Fax:
Practice Address - Street 1:125 CHURCHILL AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-3501
Practice Address - Country:US
Practice Address - Phone:609-558-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist