Healthcare Provider Details

I. General information

NPI: 1922217272
Provider Name (Legal Business Name): ELIZABETH ANNE JENNISON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ANNE HOCHULI MD

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 COLUMBIA RD MEYER-3
MORRISTOWN NJ
07960-4640
US

IV. Provider business mailing address

101 COLUMBIA RD MEYER-3
MORRISTOWN NJ
07960-4640
US

V. Phone/Fax

Practice location:
  • Phone: 973-455-3306
  • Fax: 973-455-4416
Mailing address:
  • Phone: 973-455-3306
  • Fax: 973-455-4416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number25MA08180100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: