NPI

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NPI 1134723091

Read from the NPPES registry on October 23, 2026.

Facts

Status
Active
Type
Organization
Enumeration date
2020-11-22
Last updated
2023-04-21

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Specialties

Licenses

The registry row did not include a license.

Location

Practice location
1451 Chews Landing Rd Ste 208
City
Clementon NJ
Postal code
08021-2766
Phone
(856) 352-0411

Organization contact

Name
Raytia Ellis
Title
CEO/Founder/Owner
Phone
(856) 490-8389

Medicare

PECOS
No PECOS enrollment row matched this NPI.

LEIE

No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.

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Nearby

Other NPIs in Clementon, NJ. 226 records in the public file.

Public data from NPPES and CMS. Not a credentialing determination.

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