Organization
MARVEN WALLEN & S. KENNETH JACOBSON, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVEN H WALLEN M.D. (OWNER/ADMINISTRATOR)
(973) 763-5010
Entity
Organization
Contact information
Practice address
1985 SPRINGFIELD AVE, MAPLEWOOD, NJ 07040-3435
(973) 763-5010
(973) 761-6980
Mailing address
1985 SPRINGFIELD AVE, MAPLEWOOD, NJ 07040-3435
(973) 763-5010
(973) 761-6980
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NJ
Other
Enumeration date
09/18/2007
Last updated
06/19/2008
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