Healthcare Provider Details

I. General information

NPI: 1477112910
Provider Name (Legal Business Name): ELLEN PEKAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2019
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 STANTON CHRISTIANA RD STE 102
NEWARK DE
19713-2145
US

IV. Provider business mailing address

20 BODINE RD
BERWYN PA
19312-1237
US

V. Phone/Fax

Practice location:
  • Phone: 302-892-9900
  • Fax: 302-892-9980
Mailing address:
  • Phone: 917-280-3582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT218588
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC1-0028298
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: