Provider Demographics
NPI:1700447364
Name:VALAVI, JANE CATHERINE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:CATHERINE
Last Name:VALAVI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 ROUTE 18
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2303
Mailing Address - Country:US
Mailing Address - Phone:732-613-6168
Mailing Address - Fax:
Practice Address - Street 1:418 ROUTE 18
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2303
Practice Address - Country:US
Practice Address - Phone:732-613-6168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027789363A00000X
NJ25MP00523600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant