| Elmer Family Practice,pc | |
|
475 Route 40 Elmer NJ 08318-2532 | |
| (856) 358-0770 | |
| (856) 358-0108 |
| Full Name | Elmer Family Practice,pc |
|---|---|
| Speciality | Family Medicine |
| Location | 475 Route 40, Elmer, New Jersey |
| Authorized Official Name and Position | Judy Koslick (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 8563580770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elmer Family Practice,pc Po Box 577 Elmer NJ 08318-0577 Ph: (856) 358-0770 | Elmer Family Practice,pc 475 Route 40 Elmer NJ 08318-2532 Ph: (856) 358-0770 |
| NPI Number | 1275571184 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 03/13/2013 |
| Medicare PECOS PAC ID | 7315850229 |
|---|---|
| Medicare Enrollment ID | O20031107000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275571184 | NPI | - | NPPES |
| 2124194001 | Other | NJ | AMERIHEALTH ID NUMBER |
| 4584666 | Other | NJ | AETNA ID NUMBER |
| 5174007 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Philip R Elgawli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124058102 PECOS PAC ID: 7416956669 Enrollment ID: I20061215000412 |
| Provider Name | Gerard Ventrella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639157068 PECOS PAC ID: 3678486594 Enrollment ID: I20110310001072 |
Centerton Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 798 Centerton Road, Elmer, NJ 08318 Phone: 856-358-6161 Fax: 856-358-0142 |