Tench, Mavola
Tench, Mavola is an individual health care provider with primary practice located at 1120 Delsea Dr N , Glassboro NJ 08028-1444. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Tench, Mavola can be contacted via phone (856) 582-0500.Contact Information
Primary practice address
1120 Delsea Dr N
Glassboro NJ 08028-1444
Phone: (856) 582-0500
Fax: (856) 582-0163
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25MA06318700 | New Jersey |
Profile Details
| NPI number | 1013958875 |
|---|---|
| LBN Legal business name | Tench, Mavola |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2006 |
| Last updated | Jul 30th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013958875 | NPPES |
| New Jersey | MEDICAID | 6971601 |
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