Healthcare Provider Details

I. General information

NPI: 1306735642
Provider Name (Legal Business Name): KEVIN VALCARCEL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 ROUTE 37 W STE 220
TOMS RIVER NJ
08755-5059
US

IV. Provider business mailing address

780 ROUTE 37 W STE 220
TOMS RIVER NJ
08755-5059
US

V. Phone/Fax

Practice location:
  • Phone: 732-228-4025
  • Fax: 732-505-3820
Mailing address:
  • Phone: 732-228-4025
  • Fax: 732-505-3820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number25MP00933000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: