Provider Demographics
NPI:1881805968
Name:NAYLOR, EVAN CHRISTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:CHRISTIAN
Last Name:NAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1301 ROUTE 72 W
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2483
Mailing Address - Country:US
Mailing Address - Phone:609-597-0547
Mailing Address - Fax:609-597-8668
Practice Address - Street 1:1301 ROUTE 72 W
Practice Address - Street 2:SUITE 340
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2483
Practice Address - Country:US
Practice Address - Phone:609-597-0547
Practice Address - Fax:609-597-8668
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08214500207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0157333Medicaid
NJ122058XPFMedicare PIN