Individual
ELYSA KOLVEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(800) 346-7834
Mailing address
161 LEVERINGTON AVE APT 3004, PHILADELPHIA, PA 19127-2036
(570) 862-1324
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA062089
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/09/2020
Last updated
11/23/2020
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