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General NPI Number Information
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NPI Number | 1275571184
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Entity Type | Organization
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Legal Business Name | ELMER FAMILY PRACTICE,PC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 475 ROUTE 40
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City | ELMER
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State | NJ
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Zip | 08318-2532
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Country | US
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Telephone | 856-358-0770
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Fax | 856-358-0108
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Provider Business Mailing Address
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Address Line | PO BOX 577
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City | ELMER
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State | NJ
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Zip | 08318-0577
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Country | US
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Telephone | 856-358-0770
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Fax | 856-358-0108
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | JUDY KOSLICK
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Credential |
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Telephone | 856-358-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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