Provider Demographics
NPI:1457474868
Name:SANDILOS, ELAINE PAPACOSTAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:PAPACOSTAS
Last Name:SANDILOS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 DERRY DR
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1212
Mailing Address - Country:US
Mailing Address - Phone:215-646-5654
Mailing Address - Fax:
Practice Address - Street 1:1560 DERRY DR
Practice Address - Street 2:
Practice Address - City:DRESHER
Practice Address - State:PA
Practice Address - Zip Code:19025-1212
Practice Address - Country:US
Practice Address - Phone:215-646-5654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004536L103T00000X
103TB0200X, 103TC1900X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool