Provider Demographics
NPI:1942379276
Name:PAWA, ANIL K (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:K
Last Name:PAWA
Suffix:
Gender:M
Credentials:MD
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Other - Middle Name:
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Mailing Address - Street 1:27 S COOKS BRIDGE RD
Mailing Address - Street 2:SUITE 2-21
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2524
Mailing Address - Country:US
Mailing Address - Phone:732-987-5733
Mailing Address - Fax:732-987-5729
Practice Address - Street 1:27 S COOKS BRIDGE RD
Practice Address - Street 2:SUITE 2-21
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2524
Practice Address - Country:US
Practice Address - Phone:732-987-5733
Practice Address - Fax:732-987-5729
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2014-05-28
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08128900208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0133019Medicaid