| Elissa Koplik Llc | |
|
161 S Main St Milltown NJ 08850-1800 | |
| (732) 246-4446 | |
| Not Available |
| Full Name | Elissa Koplik Llc |
|---|---|
| Speciality | Psychologist |
| Location | 161 S Main St, Milltown, New Jersey |
| Authorized Official Name and Position | Elissa K Koplik (PRESIDENT) |
| Authorized Official Contact | 7326130465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elissa Koplik Llc 161 S Main St Milltown NJ 08850-1800 Ph: () - | Elissa Koplik Llc 161 S Main St Milltown NJ 08850-1800 Ph: (732) 246-4446 |
| NPI Number | 1689874570 |
|---|---|
| Provider Enumeration Date | 07/19/2007 |
| Last Update Date | 05/08/2008 |
| Medicare PECOS PAC ID | 9537250584 |
|---|---|
| Medicare Enrollment ID | O20070807000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689874570 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 35SI00401600 (New Jersey) | Primary |
| Provider Name | Elissa K Koplik |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033133798 PECOS PAC ID: 0547351595 Enrollment ID: I20070807000037 |
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