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NPI Code Detail

MEDICARE: DR. JORGE IVAN NARVAEZ PT, DPT

MEDICARE: DR. JORGE IVAN NARVAEZ PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist40QA01870100NJ

General Provider Information

NPI Number : 1598319519
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORGE IVAN NARVAEZ PT, DPT
Provider Business Mailing Address
First Line : 1310 EMMA PL FL 1
Second Line :
City : LINDEN
State : NJ
Zip : 07036-3335
Country : US
Telephone Number : 732-430-0367
Fax Number :
Provider Business Practice Location Address
First Line : 1036 STUYVESANT AVE
Second Line :
City : UNION
State : NJ
Zip : 07083-6023
Country : US
Telephone Number : 908-851-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2019
Last Update Date : 07/29/2019

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