Provider Demographics
NPI:1265604565
Name:PALEY, JEFFREY EVAN (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:EVAN
Last Name:PALEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 N DEAN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2523
Mailing Address - Country:US
Mailing Address - Phone:201-503-0833
Mailing Address - Fax:201-503-0844
Practice Address - Street 1:177 N DEAN ST STE 203
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2523
Practice Address - Country:US
Practice Address - Phone:201-503-0833
Practice Address - Fax:201-503-0844
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211534207R00000X
NJMA75257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ083959RGPMedicare PIN
G90470Medicare UPIN
NY0Y9241Medicare PIN