Organization · Type 2 NPI
Marven Wallen & S. Kenneth Jacobson, MD PA
General Practice Physician · Maplewood, NJ
NPI number
1053507566
Active
Practice location
1985 Springfield Ave
Maplewood, NJ 07040-3435
Fax (973) 761-6980
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
2 other providers at this address
About NPI 1053507566
Marven Wallen & S. Kenneth Jacobson, MD PA's National Provider Identifier is 1053507566, issued on Sep 18, 2007. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Maplewood, NJ. The record was last updated on Jun 19, 2008.