Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marven Wallen & S. Kenneth Jacobson, MD PA

Organization General Practice Physician · NPI 1053507566

Marven Wallen & S. Kenneth Jacobson, MD PA is a General Practice Physician in Maplewood, New Jersey. Licensed in New Jersey. Registered with an NPI since 2007.

Licensed in
NJ
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1985 Springfield Ave
Maplewood, NJ 07040-3435
Phone: (973) 763-5010
Fax: (973) 761-6980
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X (NJ)

Record details

NPI number1053507566
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marven Wallen — Owner/Administrator · (973) 763-5010
NPI enumeratedSeptember 18, 2007
Last updated in NPPESJune 19, 2008
Mailing address1985 Springfield Ave, Maplewood, NJ 07040-3435

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