Provider Demographics
NPI:1730148321
Name:JAVIA, SUBHASHCHANDRA J (MD)
Entity type:Individual
Prefix:DR
First Name:SUBHASHCHANDRA
Middle Name:J
Last Name:JAVIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1968
Mailing Address - Country:US
Mailing Address - Phone:908-454-7726
Mailing Address - Fax:
Practice Address - Street 1:300 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1968
Practice Address - Country:US
Practice Address - Phone:908-454-7726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA051510002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA192736Medicare PIN
C33275Medicare UPIN
PA195994Medicare ID - Type Unspecified
NJ457562Medicare ID - Type Unspecified
NJ192739Medicare PIN