Provider Demographics
NPI:1184633927
Name:KRIPKE, ELANA N (MD)
Entity Type:Individual
Prefix:DR
First Name:ELANA
Middle Name:N
Last Name:KRIPKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1632
Mailing Address - Country:US
Mailing Address - Phone:610-695-9345
Mailing Address - Fax:610-695-9878
Practice Address - Street 1:11 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1632
Practice Address - Country:US
Practice Address - Phone:610-695-9345
Practice Address - Fax:610-695-9878
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046844L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG0007867Medicaid
PA110213696OtherRAILROAD MEDICARE
PAF26284Medicare UPIN
PA110213696OtherRAILROAD MEDICARE