Individual
DR. ELIZABETH A. MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5612 EASTON RD, PLUMSTEADVILLE, PA 18949
(215) 766-8844
Mailing address
5612 EASTON RD, P O BOX 866, PLUMSTEADVILLE, PA 18949
(215) 766-8844
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD 067086L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01741169
—
PA
01
—
066963
BLUE SHIELD
PA
Enumeration date
10/06/2005
Last updated
03/09/2010
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