1508930298 NPI number — ADAM B ELFANT MD

Table of content: ADAM B ELFANT MD (NPI 1508930298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508930298 NPI number — ADAM B ELFANT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELFANT
Provider First Name:
ADAM
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508930298
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 FELLOWSHIP RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
MOUNT LAUREL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08054-3419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-642-2133
Provider Business Mailing Address Fax Number:
856-642-2134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 FELLOWSHIP RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
MOUNT LAUREL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08054-3419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-642-2133
Provider Business Practice Location Address Fax Number:
856-642-2134
Provider Enumeration Date:
11/17/2006

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: 207RG0100X , with the licence number:  MA55617 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RG0100X , with the licence number: MD4540 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X , with the licence number: MD056201L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0514012 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1021674 . This is a "HORIZON NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110104030 . This is a "RAIL ROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 784860 . This is a "AMERIHEALTH PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000034777 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 13558 . This is a "UNIVERSITY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3643291 . This is a "AETNA US-HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: G01766C03 . This is a "DELAWARE MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P370138 . This is a "OXFORD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0809896000 . This is a "AMERIHEALTH, HMO, KEYSTONE, IBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2352993000 . This is a "AMERIHEALTH OF DE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3K6074 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6574505 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010003877 00 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1678781 . This is a "AMERIHEALTH PPO OF DE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1756340 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".




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