Provider Demographics
NPI:1689664666
Name:DE LEON, ELNORA S (MD)
Entity Type:Individual
Prefix:DR
First Name:ELNORA
Middle Name:S
Last Name:DE LEON
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 1:1091 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5450 CARLISLE PIKE
Practice Address - Street 2:BLDG 23 A
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2411
Practice Address - Country:US
Practice Address - Phone:717-605-2636
Practice Address - Fax:717-605-4074
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-21
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030106 E171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider