Provider Demographics
NPI:1669490256
Name:TEPEROV, ELIZABETH G (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:G
Last Name:TEPEROV
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:615 CHESTNUT ST
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4404
Mailing Address - Country:US
Mailing Address - Phone:215-955-1175
Mailing Address - Fax:215-955-2420
Practice Address - Street 1:833 CHESTNUT ST
Practice Address - Street 2:SUITE 701
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4414
Practice Address - Country:US
Practice Address - Phone:215-955-6180
Practice Address - Fax:215-955-6410
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD426231207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0072281Medicaid
PA093620Medicare PIN