Provider Demographics
NPI:1730818980
Name:YORK, AUDRA ELISSA (MD)
Entity type:Individual
Prefix:DR
First Name:AUDRA
Middle Name:ELISSA
Last Name:YORK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:36 S 7TH ST APT 129
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-2500
Mailing Address - Country:US
Mailing Address - Phone:614-395-9313
Mailing Address - Fax:
Practice Address - Street 1:707 HAMILTON ST FL 9
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-2407
Practice Address - Country:US
Practice Address - Phone:610-402-1764
Practice Address - Fax:484-862-3276
Is Sole Proprietor?:No
Enumeration Date:2022-06-05
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT226523208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery