Provider Demographics
NPI:1598319519
Name:NARVAEZ, JORGE IVAN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:IVAN
Last Name:NARVAEZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 EMMA PL FL 1
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-3335
Mailing Address - Country:US
Mailing Address - Phone:732-430-0367
Mailing Address - Fax:
Practice Address - Street 1:1036 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6023
Practice Address - Country:US
Practice Address - Phone:908-851-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01870100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist