Provider Demographics
NPI:1720387152
Name:NARVAEZ MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:NARVAEZ MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NORMITA
Authorized Official - Middle Name:G
Authorized Official - Last Name:LANDAS-NARVAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-743-3556
Mailing Address - Street 1:135 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5902
Mailing Address - Country:US
Mailing Address - Phone:973-743-3556
Mailing Address - Fax:
Practice Address - Street 1:135 BLOOMFIELD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5902
Practice Address - Country:US
Practice Address - Phone:973-743-3556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05047700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty