Provider Demographics
NPI:1083635510
Name:BUDNY, ELIZABETH KAREN (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KAREN
Last Name:BUDNY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:46 WALNUT BOTTOM RD
Practice Address - Street 2:
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-8219
Practice Address - Country:US
Practice Address - Phone:717-532-4148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051773363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA867633OtherMEDICARE GROUP #
PA9228304OtherAETNA NON HMO
PA50076768OtherCAPITAL BLUE CROSS
PAMA051773OtherLICENSE
PA6621873OtherAETNA HMO
PAP00841794OtherRAILROAD MEDICARE
PAMA051773OtherLICENSE
PAQ27521Medicare UPIN
PA171056LN7Medicare PIN