Provider Demographics
NPI:1629293220
Name:CARAZO, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CARAZO
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 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-926-9010
Mailing Address - Fax:215-226-8285
Practice Address - Street 1:133 W HUNTING PARK AVE
Practice Address - Street 2:SUITE 300A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2717
Practice Address - Country:US
Practice Address - Phone:215-324-0600
Practice Address - Fax:215-324-2795
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053308L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001478841Medicaid
PA100727800OtherTPI MEDICAID GROUP
PA597586OtherTPI MEDICARE GROUP
PACD4828OtherTPI RAILROAD MEDICARE GROUP