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General NPI Number Information
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NPI Number | 1356368971
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Entity Type | Individual
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Provider Name | ELAINE DENNIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 4013 ROUTE 9 N
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City | HOWELL
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State | NJ
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Zip | 07731-4021
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Country | US
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Telephone | 732-905-5255
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Fax | 732-905-5266
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Provider Business Mailing Address
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Address Line | 17 CASINO DR
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City | FARMINGDALE
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State | NJ
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Zip | 07727-3701
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Country | US
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Telephone | 732-938-3580
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD 423829
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 25MA07164700
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License Number State | NJ
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