Provider Demographics
NPI:1710178934
Name:ELKHUNOVICH, MARSHA AYZEN (MD)
Entity Type:Individual
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First Name:MARSHA
Middle Name:AYZEN
Last Name:ELKHUNOVICH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3535 MARKET ST
Mailing Address - Street 2:12TH FLOOR, SUITE 1220 - CHOP DEPT OF MSA
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3309
Mailing Address - Country:US
Mailing Address - Phone:215-590-4670
Mailing Address - Fax:215-590-2204
Practice Address - Street 1:34TH & CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4399
Practice Address - Country:US
Practice Address - Phone:215-590-1000
Practice Address - Fax:215-590-2204
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2016-07-01
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Provider Licenses
StateLicense IDTaxonomies
PAMT188294208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics