Individual
MRS. ELENA MAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
804 BELVEDERE ST, CARLISLE, PA 17013-4001
(717) 243-1653
(717) 243-6708
Mailing address
804 BELVEDERE ST, CARLISLE, PA 17013-4001
(717) 243-1653
(717) 243-6708
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
056359L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001610560
—
PA
01
—
01908001
CAPITOL BLUE CROSS PROV
PA
01
—
538947
HIGHMARK PROVIDER NUMBER
PA
Enumeration date
05/27/2006
Last updated
08/12/2015
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