Individual
DR. ELIS MILENOVA ANANIEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
120 BURRUS BLVD STE 200, BRODHEADSVILLE, PA 18322-7812
(570) 420-6300
Mailing address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD485675
PA
207Q00000X
Family Medicine Physician
MT223583
PA
Other
Enumeration date
06/22/2021
Last updated
09/25/2024
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