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Provider Information for 1801900303



DR. ALLA PAVLUSHKIN DDS

Other Name:   THOMAS RAFTERTY
Gender: FEMALE

Individual NPI: 1801900303

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1801900303
Enumeration Date 2006-08-19
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 2515 HWY 516 UNIT 2A
OLD BRIDGE, NJ 08857
United States

Phone: 732-607-0909 | Fax: 732-607-7555
View Map External Link
Primary Practice Address 2515 HWY 516 UNIT 2A EMPIRE DENTAL PC
OLD BRIDGE, NJ 08857
United States

Phone: 732-607-0909 | Fax: 732-607-7555
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NJ DI19271