Provider Demographics
NPI:1538349600
Name:GASCHO, ELIZABETH JANE (CNM)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:GASCHO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ELKINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-5252
Mailing Address - Country:US
Mailing Address - Phone:856-764-7660
Mailing Address - Fax:856-764-5723
Practice Address - Street 1:5045 ROUTE 130
Practice Address - Street 2:SUITE I
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-9707
Practice Address - Country:US
Practice Address - Phone:856-764-7660
Practice Address - Fax:856-764-5723
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25E00037301367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife