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Organization

ELMER FAMILY PRACTICE,PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUDY KOSLICK (BUSINESS OFFICE MANAGER)
(856) 358-0770
Entity
Organization

Contact information

Practice address
475 ROUTE 40, ELMER, NJ 08318-2532
(856) 358-0770
(856) 358-0108
Mailing address
PO BOX 577, ELMER, NJ 08318-0577
(856) 358-0770
(856) 358-0108

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2124194001
AMERIHEALTH ID NUMBER
NJ
01
4584666
AETNA ID NUMBER
NJ
05
5174007
NJ
Enumeration date
06/03/2006
Last updated
03/13/2013
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