Provider Demographics
NPI:1649234253
Name:LOUKA, ELIZABETH B (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:B
Last Name:LOUKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2100 KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-1129
Mailing Address - Country:US
Mailing Address - Phone:610-394-4710
Mailing Address - Fax:610-394-4721
Practice Address - Street 1:2100 KEYSTONE AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1129
Practice Address - Country:US
Practice Address - Phone:610-394-4710
Practice Address - Fax:610-394-4721
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422259207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001960085Medicaid
PA001960085Medicaid
PA071801Medicare PIN