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General NPI Number Information
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NPI Number | 1720365422
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Entity Type | Organization
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Legal Business Name | DR JOHN J NEVINS LLC
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 6 AUER CT
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5828
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Country | US
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Telephone | 732-387-8520
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Fax | 732-387-8649
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Provider Business Mailing Address
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Address Line | PO BOX 235
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City | LITTLE SILVER
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State | NJ
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Zip | 07739-0235
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Country | US
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Telephone | 732-387-8520
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Fax | 732-387-8649
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN JOSEPH NEVINS
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Credential | D.O.
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Telephone | 732-387-8520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MB52967
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License Number State | NJ
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