Healthcare Provider Details

I. General information

NPI: 1144262403
Provider Name (Legal Business Name): AYNUR A. DEVLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 HINCHMAN AVE STE 4
WAYNE NJ
07470-2360
US

IV. Provider business mailing address

401 ROUTE 73 N BLDG 10, SUITE 320
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 973-595-6996
  • Fax:
Mailing address:
  • Phone: 856-872-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA06294400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMA62944
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier7032307
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: