Provider Demographics
NPI:1184656654
Name:WASIQUE NARVEL, MD,LLC
Entity Type:Organization
Organization Name:WASIQUE NARVEL, MD,LLC
Other - Org Name:WASIQUE NARVEL, MD, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WASIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:NARVEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-696-2232
Mailing Address - Street 1:PO BOX 866
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08362-0866
Mailing Address - Country:US
Mailing Address - Phone:856-696-2232
Mailing Address - Fax:856-696-7850
Practice Address - Street 1:1138 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5053
Practice Address - Country:US
Practice Address - Phone:856-696-2232
Practice Address - Fax:856-696-7850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA72333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8577005Medicaid
NJ8577005Medicaid
NJ050374Medicare ID - Type Unspecified