Basic Information
| Provider Information | |||||||||
| NPI: | 1124091954 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DISCHMAN | ||||||||
| FirstName: | ELAINE | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 256 NEW CASTLE ROAD | ||||||||
| Address2: | |||||||||
| City: | BUTLER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242833627 | ||||||||
| FaxNumber: | 7242830968 | ||||||||
| Practice Location | |||||||||
| Address1: | 256 NEW CASTLE RD | ||||||||
| Address2: | |||||||||
| City: | BUTLER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 160012576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242833627 | ||||||||
| FaxNumber: | 7242830968 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2006 | ||||||||
| LastUpdateDate: | 01/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD042269L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 01076304A | IN | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0016555700003 | 05 | PA | MEDICAID |