Provider Demographics
NPI:1922003433
Name:COUSENS, ELISABETH MC (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:MC
Last Name:COUSENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1380 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1818
Mailing Address - Country:US
Mailing Address - Phone:215-491-5063
Mailing Address - Fax:215-491-5066
Practice Address - Street 1:1380 EASTON RD
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1818
Practice Address - Country:US
Practice Address - Phone:215-491-5063
Practice Address - Fax:215-491-5066
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058915L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA887250Medicare PIN