Provider Demographics
NPI:1740259696
Name:BEPPEL, ELAINE B (MD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:B
Last Name:BEPPEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:401 ROUTE 73 N
Mailing Address - Street 2:40 LAKE CENTER DRIVE, SUITE 201A
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3425
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0360
Practice Address - Street 1:239 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:SUITE 350
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-4002
Practice Address - Country:US
Practice Address - Phone:856-341-8181
Practice Address - Fax:856-341-8180
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06131500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8045101Medicaid
NJH00292Medicare UPIN
NJ029469YBAWMedicare PIN
NJ029469R63Medicare PIN