Provider Demographics
NPI:1225179187
Name:ELLIAS-FRANKEL, JEFFREY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:ELLIAS-FRANKEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 STATE ROUTE 34 N
Mailing Address - Street 2:SUITE 116
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1555
Mailing Address - Country:US
Mailing Address - Phone:732-780-6363
Mailing Address - Fax:
Practice Address - Street 1:29 STATE ROUTE 34 N
Practice Address - Street 2:SUITE 116
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1555
Practice Address - Country:US
Practice Address - Phone:732-780-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI 00243800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJEL666684Medicare ID - Type Unspecified