Organization
NEXT WAVE PEDIATRIC ENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN D WALKER MD (OWNER)
(609) 696-5929
Entity
Organization
Contact information
Practice address
1940 ROUTE 70 E STE 1, CHERRY HILL, NJ 08003-2141
(609) 696-5929
(609) 696-5619
Mailing address
1940 ROUTE 70 E STE 1, CHERRY HILL, NJ 08003-2141
(609) 696-5929
(609) 696-5619
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0514390
—
NJ
01
—
25MA09871200
NEW JERSEY BOARD OF MEDICAL EXAMINERS
NJ
Enumeration date
10/28/2024
Last updated
05/01/2025
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