Individual
ELLA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8835 GERMANTOWN AVE, PHILADELPHIA, PA 19118-2718
(800) 836-7536
Mailing address
8835 GERMANTOWN AVE, PHILADELPHIA, PA 19118-2718
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OT024388
PA
Other
Enumeration date
05/13/2025
Last updated
06/18/2025
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