Provider Demographics
NPI:1700675501
Name:ANDERSON, ELYSHA (MS)
Entity type:Individual
Prefix:
First Name:ELYSHA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ELYSHA
Other - Middle Name:
Other - Last Name:FINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 KNIGHTON LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2679
Mailing Address - Country:US
Mailing Address - Phone:856-577-4054
Mailing Address - Fax:
Practice Address - Street 1:505 S LENOLA RD STE 207
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-1594
Practice Address - Country:US
Practice Address - Phone:856-437-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01194700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist