Provider Demographics
NPI:1265010367
Name:NOEL, TERVICINE DELVA (MD)
Entity type:Individual
Prefix:DR
First Name:TERVICINE
Middle Name:DELVA
Last Name:NOEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 E GIBBSBORO RD
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-1907
Mailing Address - Country:US
Mailing Address - Phone:856-309-0100
Mailing Address - Fax:
Practice Address - Street 1:406 E GIBBSBORO RD
Practice Address - Street 2:
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-1907
Practice Address - Country:US
Practice Address - Phone:856-309-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12328300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine