Basic Information
| Provider Information | |||||||||
| NPI: | 1932537529 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CLAYTON | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | NOELLE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 53 SOUTH LAUREL STREET | ||||||||
| Address2: | |||||||||
| City: | BRIDGETON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564514700 | ||||||||
| FaxNumber: | 8565750818 | ||||||||
| Practice Location | |||||||||
| Address1: | 484 SOUTH BREWSTER ROAD | ||||||||
| Address2: | |||||||||
| City: | VINELAND | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564514700 | ||||||||
| FaxNumber: | 8566962561 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 25MB10061800 | NJ | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.