Individual
ELISABETH THEOPHILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 E DECATUR AVE, PLEASANTVILLE, NJ 08232-3008
(973) 771-9268
Mailing address
21 E DECATUR AVE, PLEASANTVILLE, NJ 08232-3008
(973) 771-9268
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002586-P.A
PR
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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