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General NPI Number Information
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NPI Number | 1770552325
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Entity Type | Individual
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Provider Name | ELISE S CARMAN MD
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Gender | Female
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 127 PINE ST SUITE 10
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4855
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Country | US
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Telephone | 973-655-9555
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Fax | 973-655-9559
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Provider Business Mailing Address
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Address Line | 127 PINE ST SUITE 10
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4855
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Country | US
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Telephone | 973-655-9555
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Fax | 973-655-9559
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA06437700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 25MA06437700
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License Number State | NJ
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