Individual
ELAINA LORD TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1207 CHESTNUT ST FL 5, PHILADELPHIA, PA 19107-4131
(215) 344-1632
(215) 564-8606
Mailing address
1233 LOCUST ST FL 3, PHILADELPHIA, PA 19107-5400
(215) 985-4448
(215) 732-1145
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD451461
PA
208000000X
Pediatrics Physician
MD451461
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102917878
—
PA
Enumeration date
05/17/2010
Last updated
03/17/2018
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