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Individual

ELLYN GABRIELLE DORNSEIF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
701 OSTRUM ST, SUITE 603, FOUNTAIN HILL, PA 18015-1155
(484) 526-3990
(610) 868-2915
Mailing address
701 OSTRUM ST STE 603, FOUNTAIN HILL, PA 18015-1184
(484) 526-3990
(610) 868-2915

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA057837
PA
363AM0700X
Medical Physician Assistant
Primary
MA057837
PA
363AS0400X
Surgical Physician Assistant
MA057837
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007307530136
PA
01
71812
MEDICARE
PA
Enumeration date
11/12/2015
Last updated
10/15/2025
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