Provider Demographics
NPI:1174685416
Name:EGAN, ELIZABETH A (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:EGAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:2301 E EVESHAM RD STE 110
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4502
Practice Address - Country:US
Practice Address - Phone:856-772-1600
Practice Address - Fax:856-772-9031
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2022-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08279700207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0137448Medicaid
112657VYPMedicare PIN