Provider Demographics
NPI:1578501615
Name:NARVEL, WASIQUE A (MD)
Entity Type:Individual
Prefix:DR
First Name:WASIQUE
Middle Name:A
Last Name:NARVEL
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 1:76 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-4851
Mailing Address - Country:US
Mailing Address - Phone:856-205-1112
Mailing Address - Fax:856-205-1114
Practice Address - Street 1:2950 COLLEGE DR
Practice Address - Street 2:STE 1D
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6933
Practice Address - Country:US
Practice Address - Phone:856-692-3161
Practice Address - Fax:856-692-3160
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07233300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8577005Medicaid
NJP00349232OtherRAILROAD MEDICARE
NJ050374Medicare ID - Type Unspecified
NJH46277Medicare UPIN