Individual
ELMYRA V. ENCARNACION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 E MOUNTAIN BLVD, WILKES BARRE, PA 18711-0027
(570) 808-6026
(570) 808-3208
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD422042
PA
2084N0400X
Neurology Physician
N5037
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1882268-01
—
TX
01
—
8W9869
BLUE CROSS BLUE SHIELD
TX
01
—
P00455664
RAILROAD MEDICARE
TX
Enumeration date
05/31/2006
Last updated
07/10/2020
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