Individual
ELIZABETH M. ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 9329, PHILADELPHIA, PA 19104-4399
(215) 590-1858
(215) 590-1415
Mailing address
100 EAST PENN SQUARE, THE WANAMAKER BUILDING, 9TH FLOOR, PHILADELPHIA, PA 19104-4399
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
MD444184
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027606260001
—
PA
01
—
249352EJL
MEDICARE PTAN
PA
Enumeration date
06/03/2007
Last updated
04/18/2013
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