1477796811 NPI number — DR. JENNIFER GRANTHAM ERSKINE MD

Table of content: (NPI 1144237140)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477796811 NPI number — DR. JENNIFER GRANTHAM ERSKINE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ERSKINE
Provider First Name:
JENNIFER
Provider Middle Name:
GRANTHAM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CANCRO
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
ERSKINE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477796811
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
253 WITHERSPOON ST
Provider Second Line Business Mailing Address:
LAMBERT HOUSE 2ND FLOOR
Provider Business Mailing Address City Name:
PRINCETON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08540-3211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-817-4546
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
253 WITHERSPOON ST
Provider Second Line Business Practice Location Address:
LAMBERT HOUSE 2ND FLOOR
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08540-3211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-817-4546
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/15/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208M00000X , with the licence number:  MD072560-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 25MA08590100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 25MA08590100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: C1-0024355 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: MD072560-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: C1-0024355 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)