Individual
ELYSSA C. DRUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12 PENNLYN RD, SOUTHAMPTON, PA 18966-1046
(215) 350-2803
Mailing address
12 PENNLYN RD, SOUTHAMPTON, PA 18966-1046
(215) 350-2803
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29960138
DRIVER'S LICENSE
PA
Enumeration date
09/23/2020
Last updated
09/23/2020
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