Healthcare Provider Details

I. General information

NPI: 1801967666
Provider Name (Legal Business Name): MARVALYN ELIZABETH DECAMBRE M.D. MPH, FAAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PEDIATRIC ADOLESCENT CONTINENCE UROLOGY MARVALYN DECAMBRE MD MPH FAAP

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S LIVINGSTON AVE STE 2F
LIVINGSTON NJ
07039-4040
US

IV. Provider business mailing address

201 S LIVINGSTON AVE STE 2F
LIVINGSTON NJ
07039-4040
US

V. Phone/Fax

Practice location:
  • Phone: 973-533-6863
  • Fax: 651-855-5057
Mailing address:
  • Phone: 973-533-6863
  • Fax: 651-855-5057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number25MA10148300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number25MA10148300
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License NumberME129485
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: