Basic Information
| Provider Information | |||||||||
| NPI: | 1215295316 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOREL | ||||||||
| FirstName: | ELYSE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 755 MEMORIAL PKWY | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | PHILLIPSBURG | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088652748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9084546303 | ||||||||
| FaxNumber: | 9084542289 | ||||||||
| Practice Location | |||||||||
| Address1: | 755 MEMORIAL PKWY | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | PHILLIPSBURG | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088652748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9084546303 | ||||||||
| FaxNumber: | 9084542289 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2012 | ||||||||
| LastUpdateDate: | 10/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 25MA09765300 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.