Individual
EMILY TAKHTAROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
141 ROUTE 70 E STE B, MARLTON, NJ 08053-1855
(856) 596-9057
(856) 596-0837
Mailing address
141 ROUTE 70 E STE B, MARLTON, NJ 08053-1855
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR26058900
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ15114400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028596
—
NJ
Enumeration date
07/18/2024
Last updated
11/11/2024
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