Provider Demographics
NPI:1679707137
Name:ERYAZICI, PAULA DE LIMA (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:DE LIMA
Last Name:ERYAZICI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:DE LIMA
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:207 N BROAD ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1500
Mailing Address - Country:US
Mailing Address - Phone:215-361-5020
Mailing Address - Fax:215-362-1195
Practice Address - Street 1:125 MEDICAL CAMPUS DR STE 101
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-7205
Practice Address - Country:US
Practice Address - Phone:215-361-5020
Practice Address - Fax:215-362-1195
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036122692207RC0000X
MS22517207RC0000X
PAMD457590207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032468200002Medicaid
MS02904837Medicaid