Healthcare Provider Details

I. General information

NPI: 1144291485
Provider Name (Legal Business Name): ENIKO KOVATS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ENIKO ONGRADI MD

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 OLD YORK ROAD SUITE 202
JENKINTOWN PA
19046
US

IV. Provider business mailing address

101 E OLNEY AVE 400
PHILADELPHIA PA
19120-2470
US

V. Phone/Fax

Practice location:
  • Phone: 267-763-1060
  • Fax:
Mailing address:
  • Phone: 215-254-2630
  • Fax: 215-254-2599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD049661L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0014223360007
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: