Healthcare Provider Details

I. General information

NPI: 1952468803
Provider Name (Legal Business Name): ELYNNE B. MARGULIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 06/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 E BROAD ST
WESTFIELD NJ
07090-2116
US

IV. Provider business mailing address

522 E BROAD ST
WESTFIELD NJ
07090-2116
US

V. Phone/Fax

Practice location:
  • Phone: 908-232-2639
  • Fax: 908-232-3575
Mailing address:
  • Phone: 908-232-2639
  • Fax: 908-232-3575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA05262700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: