Provider Demographics
NPI:1003886516
Name:MORDAN, ELIEZER AURELINA (MD)
Entity Type:Individual
Prefix:MISS
First Name:ELIEZER
Middle Name:AURELINA
Last Name:MORDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 BRANDON AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-4043
Mailing Address - Country:US
Mailing Address - Phone:856-912-9750
Mailing Address - Fax:
Practice Address - Street 1:1 DIAMOND HILL RD FL 1
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2104
Practice Address - Country:US
Practice Address - Phone:908-277-8880
Practice Address - Fax:908-277-8796
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07783600207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0073067Medicaid