Individual
DR. DONNA LEONNE ELCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
538 CHURCH LN, YEADON, PA 19050-3102
(610) 284-0777
Mailing address
538 CHURCH LN, YEADON, PA 19050-3102
(610) 284-0777
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OEG001054
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01622622
—
PA
01
—
0530914000
KEYSTONE HEALTH PLAN EAST
PA
01
—
695858
PERSONAL CHOICE/ BLUE CHO
PW
01
—
73236
AETNA
PA
Enumeration date
04/19/2006
Last updated
02/28/2014
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