Provider Demographics
NPI:1104176106
Name:AKL, ELIAS (MD)
Entity type:Individual
Prefix:
First Name:ELIAS
Middle Name:
Last Name:AKL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 WALNUT ST STE 902
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5451
Mailing Address - Country:US
Mailing Address - Phone:215-315-7642
Mailing Address - Fax:215-929-8302
Practice Address - Street 1:1608 WALNUT ST STE 902
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5451
Practice Address - Country:US
Practice Address - Phone:215-315-7642
Practice Address - Fax:215-929-8302
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11165900207K00000X
PAMD469878207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology