Divyak, Elizabeth A

Divyak, Elizabeth A is an individual health care provider with primary practice located at 700 S Park St , Madison WI 53715-1830. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Divyak, Elizabeth A can be contacted via phone (608) 251-6100.

Contact Information

Primary practice address
700 S Park St Madison WI 53715-1830
Phone: (608) 251-6100
Fax: (608) 258-6259
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 3013-154 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5122-23 Wisconsin

Profile Details

NPI number 1174710560
LBN Legal business name Divyak, Elizabeth A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2007
Last updated Jan 18th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174710560 NPPES
Wisconsin MEDICAID 1174710560

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