Individual
ELAINE H ZACKAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - GENETICS, PHILADELPHIA, PA 19104-4319
(215) 590-2920
(215) 590-3298
Mailing address
100 E PENN SQ, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9258
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
207SC0300X
Clinical Cytogenetics Physician
25MA07256800
NJ
207SC0300X
Clinical Cytogenetics Physician
MD014103E
PA
207SG0201X
Clinical Genetics (M.D.) Physician
25MA07256800
NJ
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
MD014103E
PA
208000000X
Pediatrics Physician
25MA07256800
NJ
208000000X
Pediatrics Physician
MD014103E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000665287
—
PA
05
—
0328600
—
NJ
Enumeration date
08/02/2006
Last updated
10/27/2014
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