Healthcare Provider Details

I. General information

NPI: 1881674943
Provider Name (Legal Business Name): ELENA NAPOLITANO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 JACK MARTIN BLVD
BRICK NJ
08724-7732
US

IV. Provider business mailing address

425 JACK MARTIN BLVD
BRICK NJ
08724-7732
US

V. Phone/Fax

Practice location:
  • Phone: 732-836-4504
  • Fax: 732-836-4532
Mailing address:
  • Phone: 732-836-4504
  • Fax: 732-836-4532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberMA07589100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: