Individual
KENNETH M. IRVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
860 S WHITE HORSE PIKE, HAMMONTON, NJ 08037-2018
(609) 567-0200
(609) 567-1169
Mailing address
860 S WHITE HORSE PIKE, HAMMONTON, NJ 08037-2018
(609) 567-0200
(609) 567-1169
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA08082600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110779
—
NJ
Enumeration date
07/18/2006
Last updated
07/11/2007
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