Provider Demographics
NPI:1851368849
Name:ESTRADA, ELSIE C (MD)
Entity Type:Individual
Prefix:DR
First Name:ELSIE
Middle Name:C
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PARROTT MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2744
Mailing Address - Country:US
Mailing Address - Phone:973-635-4511
Mailing Address - Fax:973-701-1520
Practice Address - Street 1:12 PARROTT MILL RD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2744
Practice Address - Country:US
Practice Address - Phone:973-635-4511
Practice Address - Fax:973-701-1520
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05279000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics