Provider Demographics
NPI:1609890946
Name:ANTONELLI, ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:
Last Name:ANTONELLI
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:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:PENNS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:18943-0039
Mailing Address - Country:US
Mailing Address - Phone:215-598-9872
Mailing Address - Fax:215-598-9874
Practice Address - Street 1:842 DURHAM RD
Practice Address - Street 2:SUITE 13
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-9683
Practice Address - Country:US
Practice Address - Phone:215-598-9872
Practice Address - Fax:215-598-9874
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028802E2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine