Provider Demographics
NPI:1225138290
Name:ELMANN, ELIE M (MD)
Entity Type:Individual
Prefix:MR
First Name:ELIE
Middle Name:M
Last Name:ELMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:201-996-2261
Mailing Address - Fax:201-343-0609
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 900
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-996-2261
Practice Address - Fax:201-343-0609
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06300100208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6711600Medicaid
G19792Medicare UPIN
NJEL811109Medicare ID - Type Unspecified