Provider Demographics
NPI:1336442235
Name:PAV, PLLC
Entity Type:Organization
Organization Name:PAV, PLLC
Other - Org Name:PODIATRY ASSOCIATES OF VIRGINIA, NORFOLK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-962-4991
Mailing Address - Street 1:936A GENERAL BOOTH BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-4857
Mailing Address - Country:US
Mailing Address - Phone:757-228-1955
Mailing Address - Fax:757-228-3095
Practice Address - Street 1:902A GRAYDON AVE
Practice Address - Street 2:PODIATRY
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1208
Practice Address - Country:US
Practice Address - Phone:757-962-4991
Practice Address - Fax:757-962-5993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAV, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies