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General NPI Number Information
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NPI Number | 1265010367
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Entity Type | Individual
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Provider Name | TERVICINE DELVA NOEL MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 406 E GIBBSBORO RD
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City | LINDENWOLD
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State | NJ
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Zip | 08021-1907
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Country | US
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Telephone | 856-309-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 406 E GIBBSBORO RD
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City | LINDENWOLD
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State | NJ
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Zip | 08021-1907
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Country | US
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Telephone | 856-309-0100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA12328300
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License Number State | NJ
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