Provider Demographics
NPI:1780711382
Name:ELMORE, ERIN M (MD)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:M
Last Name:ELMORE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:81 NORTHFIELD AVENUE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052
Mailing Address - Country:US
Mailing Address - Phone:973-373-8000
Mailing Address - Fax:973-373-5265
Practice Address - Street 1:81 NORTHFIELD AVENUE
Practice Address - Street 2:SUITE 301
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052
Practice Address - Country:US
Practice Address - Phone:973-373-8000
Practice Address - Fax:973-373-5265
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2015-10-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ733492084N0400X
NY2118972084N0400X
NJ25MA073349002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03023452Medicaid
NJH54293Medicare UPIN