Provider Demographics
NPI:1467527697
Name:ELMER PEDIATRICS OF MULLICA HILL
Entity Type:Organization
Organization Name:ELMER PEDIATRICS OF MULLICA HILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MED
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-459-2270
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD ST
Mailing Address - State:NJ
Mailing Address - Zip Code:08313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 BRIDGETON PIKE
Practice Address - Street 2:SUITE E
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062
Practice Address - Country:US
Practice Address - Phone:856-478-0399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty