Provider Demographics
NPI:1215463658
Name:MCGEEHIN, ELENI
Entity type:Individual
Prefix:
First Name:ELENI
Middle Name:
Last Name:MCGEEHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELENI
Other - Middle Name:
Other - Last Name:MARMARELIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:531 W GERMANTOWN PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1325
Mailing Address - Country:US
Mailing Address - Phone:610-828-0400
Mailing Address - Fax:
Practice Address - Street 1:531 W GERMANTOWN PIKE STE 200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1325
Practice Address - Country:US
Practice Address - Phone:610-828-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD4722705207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program