Provider Demographics
NPI:1104831973
Name:ELBER, LEE B (DO)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:B
Last Name:ELBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 95000 LB# 7550
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7550
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:102 JAMES ST
Practice Address - Street 2:SUITE 202
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3970
Practice Address - Country:US
Practice Address - Phone:732-548-5541
Practice Address - Fax:732-548-2610
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB06839300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8948305Medicaid
NJ8948305Medicaid
NJ027675Medicare ID - Type Unspecified