Provider Demographics
NPI:1619931904
Name:ELKUS, PEGGY H (PHD)
Entity Type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:H
Last Name:ELKUS
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 1:7530 CARRIAGE LANE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15521-3221
Mailing Address - Country:US
Mailing Address - Phone:412-243-0337
Mailing Address - Fax:412-243-3609
Practice Address - Street 1:7530 CARRIAGE LANE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15521-3221
Practice Address - Country:US
Practice Address - Phone:412-243-0337
Practice Address - Fax:412-243-3609
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSOO6594L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical