MEDICARE: ANDREA ELISA PAPA-MOLTER D.O

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	25MB09249100	NJ
2	2084P0800X	Psychiatry Physician	OT012604	PA

General Provider Information

NPI Number	:	1619130499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA ELISA PAPA-MOLTER D.O

Provider Business Mailing Address
First Line	:	1906 QUEEN ANNE RD
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08003-2844
Country	:	US
Telephone Number	:	215-205-5473
Fax Number	:

Provider Business Practice Location Address
First Line	:	1395 CHEWS LANDING RD
Second Line	:
City	:	LAUREL SPRINGS
State	:	NJ
Zip	:	08021-2760
Country	:	US
Telephone Number	:	856-530-0866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2008
Last Update Date	:	07/10/2019

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