Individual
DR. ELI LOURIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 S BROAD ST FL 3, PHILADELPHIA, PA 19145
(267) 425-1666
Mailing address
1700 S BROAD ST FL 3, PHILADELPHIA, PA 19145-2340
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD-0646420-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001692814
—
PA
Enumeration date
08/05/2006
Last updated
03/21/2019
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