Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MA46895 | NJ |
NPI | 1073736005 |
---|---|
Provider Name | Dr. Michele Elkins |
First Address | Berkeley Heights, NJ 07922-2322 |
Second Address | Berkeley Heights, NJ 07922-2322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 16/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
71234181J | (05) | NJ |