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NPI 1669717864

OrganizationActive

Avenel Iselin Medical Group, LLC

NPI 1669717864 · Non-Pharmacy Dispensing Site · Iselin, NJ

Provider details

NPI number: 1669717864
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc.
Authorized official: Kenny Heine, Vp Ops
License: 25MA05991500 (NJ)

Practice location

400 Gill Ln

1

Iselin, NJ 08830-3059

Phone: (732) 404-1580

More NJ providers

Mailing address

5626 Oberlin Dr

San Diego, CA 92121-1705

Registry dates

Enumerated: 2012-11-29
Last updated: 2024-10-04

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Avenel Iselin Medical Group, LLC — NPI 1669717864, Iselin, NJ | NPI Central