Individual
ELAINE BACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
565 HWY 35 NORTH, RED BANK, NJ 07701
(732) 219-7140
(732) 219-7177
Mailing address
2130 HIGHWAY 35, STE 324, SEA GIRT, NJ 08750-1011
(732) 974-1980
(732) 974-2117
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MB66800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7966300
—
NJ
Enumeration date
07/21/2006
Last updated
04/09/2018
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