Excelsia PA, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

EXCELSIA PA, PLLC

Practice address

901 W Ashland Ave
Glenolden, PA 19036-1101

Phone

(610) 461-6450

NPI assigned

Nov 14, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Constantine Misoul

Title

Medical Director

Phone

(410) 933-5678

Specialties & licenses 1

Addresses

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1831807304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR STE 417",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212201409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W ASHLAND AVE",
            "city": "GLENOLDEN",
            "state": "PA",
            "postal_code": "190361101",
            "telephone_number": "610-461-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIA PA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "MISOUL",
        "authorized_official_first_name": "CONSTANTINE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-933-5678"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EXCL",
            "affiliation": "N",
            "address_1": "901 W Ashland Ave",
            "city": "Glenolden",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190361101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elwyn
• Elwyn
• Elwyn of Pennsylvania and Delaware
• Danielle Leah Evans, PA-C
• Exalted Life Home Care LLC
• Eye Site
• Larry Eric Farmer, M.S.,
• Donna Marie Fedena, P.T.A
• Cynthia Theresa Fehrle, PT
• Shawn Frampton

• Specialist in Glenolden, PA
• Providers in Glenolden, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.