Provider Demographics
NPI:1922217272
Name:JENNISON, ELIZABETH ANNE (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:JENNISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:HOCHULI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:101 COLUMBIA RD
Mailing Address - Street 2:MEYER-3
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4640
Mailing Address - Country:US
Mailing Address - Phone:973-455-3306
Mailing Address - Fax:973-455-4416
Practice Address - Street 1:101 COLUMBIA RD
Practice Address - Street 2:MEYER-3
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4640
Practice Address - Country:US
Practice Address - Phone:973-455-3306
Practice Address - Fax:973-455-4416
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA081801002083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine