Provider Demographics
NPI:1235118555
Name:SMOLSKY, ELIZABETH ANN (MSN, APN, C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:SMOLSKY
Suffix:
Gender:F
Credentials:MSN, APN, C
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:103 OLD MARLTON PIKE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8772
Mailing Address - Country:US
Mailing Address - Phone:609-953-7111
Mailing Address - Fax:609-953-1544
Practice Address - Street 1:103 OLD MARLTON PIKE
Practice Address - Street 2:SUITE 111
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8772
Practice Address - Country:US
Practice Address - Phone:609-953-7111
Practice Address - Fax:609-953-1544
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2016-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00026000207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0017141Medicaid
NJQ05919Medicare UPIN
NJ0017141Medicaid