Individual
MS. MAVOLA TENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 DELSEA DR N, GLASSBORO, NJ 08028-1444
(856) 582-0500
(856) 582-0163
Mailing address
1120 DELSEA DR N, GLASSBORO, NJ 08028-1444
(856) 582-0500
(856) 582-0163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA06318700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6971601
—
NJ
Enumeration date
06/10/2006
Last updated
07/30/2008
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