Evans, Benjamin Marvin

Evans, Benjamin Marvin is an individual health care provider with primary practice located at 155 Jefferson St Mental Health-4W, Newark NJ 07105-1706. He recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, Adult, which is considered as his primary health care specialty. Evans, Benjamin Marvin can be contacted via phone (973) 465-2605.

Contact Information

Primary practice address
155 Jefferson St Mental Health-4W Newark NJ 07105-1706
Phone: (973) 465-2605
Fax: (973) 465-2829
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health, Adult 163WP0809X 26NC07677700 New Jersey

Profile Details

NPI number 1912981853
LBN Legal business name Evans, Benjamin Marvin
Credentials RN APN-C
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912981853 NPPES
New Jersey MEDICAID 6741100

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