Provider Demographics
NPI:1356760631
Name:VERRICO, ELIZABETH (DO)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:VERRICO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:25 ROCKWOOD PL STE 405
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4960
Mailing Address - Country:US
Mailing Address - Phone:201-225-1811
Mailing Address - Fax:201-616-7789
Practice Address - Street 1:25 ROCKWOOD PL STE 405
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4960
Practice Address - Country:US
Practice Address - Phone:201-225-1811
Practice Address - Fax:201-616-7789
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS0220282086S0122X
NJ25MB115403002086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery