Provider Demographics
NPI:1447862800
Name:ELLNER, DAVID ALEXANDER (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALEXANDER
Last Name:ELLNER
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 ROUTE 23
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416-2004
Mailing Address - Country:US
Mailing Address - Phone:973-864-3202
Mailing Address - Fax:
Practice Address - Street 1:245 ROUTE 23
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416-2004
Practice Address - Country:US
Practice Address - Phone:973-864-3202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04009000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist