Provider Demographics
NPI:1700058385
Name:DISHLER, ELYSE (MD)
Entity Type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:DISHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8001 ROUTE 130
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1870
Mailing Address - Country:US
Mailing Address - Phone:856-461-1400
Mailing Address - Fax:856-461-2366
Practice Address - Street 1:1930 MARLTON PIKE EAST STE A-1
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003
Practice Address - Country:US
Practice Address - Phone:562-613-1688
Practice Address - Fax:856-751-0607
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06816200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine