Provider Demographics
NPI:1528525318
Name:DALUPANG, ELISA ROCHELLE (PT)
Entity type:Individual
Prefix:
First Name:ELISA ROCHELLE
Middle Name:
Last Name:DALUPANG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ELISA ROCHELLE
Other - Middle Name:C
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5903 LEBEN DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2899
Mailing Address - Country:US
Mailing Address - Phone:443-683-0473
Mailing Address - Fax:
Practice Address - Street 1:8507 MAPLEVILLE RD
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-1818
Practice Address - Country:US
Practice Address - Phone:301-671-5182
Practice Address - Fax:301-671-5150
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist