Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD026593E | PA |
Y | 111NI0900X | Internist | MD026593E | PA |
NPI | 1003804501 |
---|---|
Provider Name | Indranee Elanchenny |
First Address | West Chester, PA 19380-1894 |
Second Address | Coatesville, PA 19320-2040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 06/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
019312 | AETNA (01) | |
087712 | PABS-P4 (01) | PA |