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General NPI Number Information
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NPI Number | 1902019797
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Entity Type | Individual
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Provider Name | CHERIE ELFENBEIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 183 INWOOD AVE
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City | MONTCLAIR
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State | NJ
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Zip | 07043-1908
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Country | US
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Telephone | 973-509-1125
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Fax | 973-509-6597
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Provider Business Mailing Address
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Address Line | 27 WARREN PL
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2528
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Country | US
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Telephone | 973-509-1125
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA07143500
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License Number State | NJ
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