Provider Demographics
NPI:1689943706
Name:NEGRIN, ELSA
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:
Last Name:NEGRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 AVON DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-5600
Mailing Address - Country:US
Mailing Address - Phone:609-918-0330
Mailing Address - Fax:609-918-0331
Practice Address - Street 1:685 AVON DR
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-5600
Practice Address - Country:US
Practice Address - Phone:609-918-0330
Practice Address - Fax:609-918-0331
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00357000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily