Provider Demographics
NPI:1053088856
Name:MVLD CONSULTING LLC
Entity Type:Organization
Organization Name:MVLD CONSULTING LLC
Other - Org Name:MY NJ TESTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MICCAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTTLYEW
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:908-403-5703
Mailing Address - Street 1:113 ELLIOTT PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-1909
Mailing Address - Country:US
Mailing Address - Phone:908-403-5703
Mailing Address - Fax:
Practice Address - Street 1:113 ELLIOTT PL
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-1909
Practice Address - Country:US
Practice Address - Phone:646-535-6440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty