Individual
ELAINA FRAGOULIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-3834
Mailing address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OT022579
PA
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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