Provider Demographics
NPI:1477112910
Name:PEKAR, ELLEN
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:PEKAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BODINE RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-1237
Mailing Address - Country:US
Mailing Address - Phone:917-280-3582
Mailing Address - Fax:
Practice Address - Street 1:537 STANTON CHRISTIANA RD STE 102
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2145
Practice Address - Country:US
Practice Address - Phone:302-892-9900
Practice Address - Fax:302-892-9980
Is Sole Proprietor?:No
Enumeration Date:2019-06-09
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT218588208600000X
DEC1-0028298208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery