Basic Information
| Provider Information | |||||||||
| NPI: | 1083635510 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUDNY | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | KAREN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 46 WALNUT BOTTOM RD | ||||||||
| Address2: | |||||||||
| City: | SHIPPENSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172578219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175324148 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 08/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA051773 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | MB1149764 | 01 | PA | DEA | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | 9228304 | 01 | PA | AETNA NON HMO | OTHER | 6621873 | 01 | PA | AETNA HMO | OTHER | P00841794 | 01 | PA | RAILROAD MEDICARE | OTHER | 50076768 | 01 | PA | CAPITAL BLUE CROSS | OTHER | MA051773 | 01 | PA | LICENSE | OTHER |