Provider Demographics
NPI:1255776092
Name:CHONG, ELISE A (MD)
Entity type:Individual
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First Name:ELISE
Middle Name:A
Last Name:CHONG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:PERELMAN CENTER, 10TH FLOOR, SOUTH PAVILION EXTENSION
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5127
Mailing Address - Country:US
Mailing Address - Phone:215-662-4000
Mailing Address - Fax:215-662-4381
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:PERELMAN CENTER, 10TH FLOOR, SOUTH PAVILION EXTENSION
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-662-4000
Practice Address - Fax:215-662-4381
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2019-10-30
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Provider Licenses
StateLicense IDTaxonomies
PAMD455025207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology