NPI 1194267682

Denise Tyler

Practitioner Preferred Provider Organization Phila, PA

Practice location

Address: 7919 Fayette St, Phila, PA 19150-2103
Phone: (267) 402-0108

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence JI112924P6 (PA)

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Registry record

NPI: 1194267682
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Nov 2016
Record last updated: 15 Nov 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.