Provider Demographics
NPI:1851403166
Name:POSOLI, ELIZABETH (PA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:POSOLI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 PENINSULA FARM RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-1013
Mailing Address - Country:US
Mailing Address - Phone:410-518-9808
Mailing Address - Fax:410-518-9842
Practice Address - Street 1:269 PENINSULA FARM RD
Practice Address - Street 2:SUITE F
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-1013
Practice Address - Country:US
Practice Address - Phone:410-518-9808
Practice Address - Fax:410-518-9842
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1012363A00000X
MDC0002169363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100511090Medicaid
NV100511091OtherMEDICAID
NV1851403166OtherSMA MEDICAID NUMBER APPROVED
NV103187OtherSMA MEDICARE UPIN
NV103187Medicare PIN
NV103187OtherSMA MEDICARE UPIN