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NPI Code Detail

MEDICARE: INDRANEE ELANCHENNY M.D

MEDICARE: INDRANEE ELANCHENNY M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD026593EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1019312OTHERAETNA
2087712OTHERPAPABS-P4

General Provider Information

NPI Number : 1003804501
Entity Type Code : Individual
Provider Name (Legal Business Name) : INDRANEE ELANCHENNY M.D
Provider Business Mailing Address
First Line : 889 HARMONY HILL RD
Second Line :
City : WEST CHESTER
State : PA
Zip : 19380-1894
Country : US
Telephone Number : 610-269-8931
Fax Number :
Provider Business Practice Location Address
First Line : 1400 BLACKHORSE HILL RD
Second Line :
City : COATESVILLE
State : PA
Zip : 19320-2040
Country : US
Telephone Number : 610-384-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2005
Last Update Date : 07/21/2022

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