Individual
ELYSSA KLEINWAKS HEISEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1991 SPROUL RD STE 140, BROOMALL, PA 19008-3518
(610) 325-0309
Mailing address
1991 SPROUL RD STE 140, BROOMALL, PA 19008-3518
(610) 325-0309
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS025549
PA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
05/27/2026
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