MEDICARE: GINGER ELIAS

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
1	163WE0003X	Emergency Registered Nurse	797035	PA

General Provider Information

NPI Number	:	1760337943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINGER ELIAS

Provider Business Mailing Address
First Line	:	1628 GREEN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3910
Country	:	US
Telephone Number	:	914-574-1319
Fax Number	:

Provider Business Practice Location Address
First Line	:	1628 GREEN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3910
Country	:	US
Telephone Number	:	914-574-1319
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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