Healthcare Provider Details

I. General information

NPI: 1649245473
Provider Name (Legal Business Name): ELENA ESPADA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 02/14/2020
Certification Date: 02/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 ROUTE 70 E
CHERRY HILL NJ
08003-4501
US

IV. Provider business mailing address

1902 FAIRFAX AVE
CHERRY HILL NJ
08003-2007
US

V. Phone/Fax

Practice location:
  • Phone: 856-827-7642
  • Fax: 856-827-7640
Mailing address:
  • Phone: 856-827-7630
  • Fax: 856-827-7640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: