Provider Demographics
NPI:1689755860
Name:EPSTEIN, JEFFREY ERROL (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ERROL
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 ROUTE 130 SOUTH
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-2521
Mailing Address - Country:US
Mailing Address - Phone:856-764-4115
Mailing Address - Fax:856-764-4116
Practice Address - Street 1:2906 ROUTE 130 SOUTH
Practice Address - Street 2:SUITE 201
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-2521
Practice Address - Country:US
Practice Address - Phone:856-764-4115
Practice Address - Fax:856-764-4116
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05429000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5089409Medicaid
NJE98998Medicare UPIN
NJ688849Medicare ID - Type Unspecified