Provider Demographics
NPI:1053350165
Name:MCLAUGHLIN, ELGIE ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:ELGIE
Middle Name:ROSE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-8365
Mailing Address - Country:US
Mailing Address - Phone:215-663-1779
Mailing Address - Fax:215-663-1790
Practice Address - Street 1:821 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 204
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-8365
Practice Address - Country:US
Practice Address - Phone:215-663-1779
Practice Address - Fax:215-663-1790
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039124E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC33595Medicare UPIN