Provider Demographics
NPI:1932178159
Name:THOMAS, ELISE F (MD)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:F
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:
Other - Last Name:FULIGNI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-4240
Mailing Address - Fax:717-848-5520
Practice Address - Street 1:2050 S QUEEN ST
Practice Address - Street 2:STE 100
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4829
Practice Address - Country:US
Practice Address - Phone:717-812-4240
Practice Address - Fax:717-848-5520
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187530208000000X
PAMD430907208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA206265OtherUNISON-WMG
PA210458OtherJOHNS HOPKINS
PA1959098OtherHIGHMARK BLUE SHIELD
PA7360336OtherAETNA
PAP008453OtherGATEWAY-WMG
PA101856633Medicaid
PA20061847OtherAMERIHEALTH MERCY-WMG
PA50068113OtherCAPITAL BLUE CROSS-WMG
PA107821OtherGEISINGER
PA1959098OtherHIGHMARK BLUE SHIELD
NYG63986Medicare UPIN
PA210458OtherJOHNS HOPKINS