Individual
MS. ELIZABETH ANN ILIESCU OUTLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
132 S 10TH ST, PHILADELPHIA, PA 19107-5244
(215) 955-6840
Mailing address
132 S 10TH ST, PHILADELPHIA, PA 19107-5244
(215) 955-6840
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA53846
CA
363AM0700X
Medical Physician Assistant
Primary
MA066645
PA
Other
Enumeration date
07/11/2016
Last updated
09/05/2025
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