Provider Demographics
NPI:1780758078
Name:ELMER PEDIATRICS
Entity type:Organization
Organization Name:ELMER PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-358-5050
Mailing Address - Street 1:PO BOX 603
Mailing Address - Street 2:
Mailing Address - City:ELMER
Mailing Address - State:NJ
Mailing Address - Zip Code:08318
Mailing Address - Country:US
Mailing Address - Phone:856-358-5050
Mailing Address - Fax:856-358-1141
Practice Address - Street 1:525 STATE STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:ELMER
Practice Address - State:NJ
Practice Address - Zip Code:08318
Practice Address - Country:US
Practice Address - Phone:856-358-5050
Practice Address - Fax:856-358-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty