Provider Demographics
NPI:1689664773
Name:PAVLAK-SCHENK, JAYNE (DO)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:PAVLAK-SCHENK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 ROUTE 88 W
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3009
Mailing Address - Country:US
Mailing Address - Phone:732-840-8880
Mailing Address - Fax:732-840-3939
Practice Address - Street 1:1608 ROUTE 88 W
Practice Address - Street 2:SUITE 250
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3009
Practice Address - Country:US
Practice Address - Phone:732-840-8880
Practice Address - Fax:732-840-3939
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB04677600207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ112402OtherCHN
NJ2337434OtherAETNA
NJ5042801Medicaid
NJ3819175002OtherCIGNA
NJ830006946OtherMEDICARE RAILROAD
NJ040046776NJ01OtherANTHEM
NJ71679OtherLOCAL 825
NJ855791OtherEMPIRE HEALTHCARE
NJ38470OtherMASTERCARE
NJ6101430OtherGHI
NJ2337434OtherAETNA
NJ112402OtherCHN