Dr Douglas Jan Pravda, DO is a
Dermatology physician based in Kenilworth, New Jersey. Dr Douglas Jan Pravda is licensed to practice in New Jersey (license number 25MB03272500) and his current practice location is 622 Boulevard, Kenilworth, New Jersey. He can be reached at his office (for appointments etc.) via phone at
(908) 241-3181.
NPI number for Dr Douglas Jan Pravda is 1427020718 and his current mailing address is 287 Watchung Frk, Westfield, New Jersey. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1427020718.
Physician's Profile
| Full Name | Dr Douglas Jan Pravda |
|---|
| Gender | Male |
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| Speciality | Dermatology |
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| Location | 622 Boulevard, Kenilworth, New Jersey |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1427020718
- Provider Enumeration Date: 02/02/2006
- Last Update Date: 06/25/2010
Medical Identifiers
Medical identifiers for Dr Douglas Jan Pravda such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427020718 | NPI | - | NPPES |
| 10664103 | Other | NJ | UNIVERSAL CREDENTIALING |
| US-292 | Other | NH | OXFORD INSURANCE |
| 127381096 | Other | NJ | OTHER INSURANCE COMPANIES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | 25MB03272500 (New Jersey) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Douglas Jan Pravda is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Douglas Jan Pravda, DO
287 Watchung Frk,
Westfield, NJ 07090-3816
Ph: (908) 233-7383 | Dr Douglas Jan Pravda, DO
622 Boulevard,
Kenilworth, NJ 07033-1640
Ph: (908) 241-3181 |
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