Vincent Tyson

NPI 1003245457 - Nurse Practitioner - 363LP2300X

NPI Details
NPI 1003245457
Gender Male
Enumeration Date 11/06/2013
Last Updated 11/06/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
760 CARPENTER LN
PHILADELPHIA PA, 19119-3406, US
Phone (215) 848-6880
Fax
Business Location
760 CARPENTER LN
PHILADELPHIA PA, 19119-3406, US
Phone (215) 848-6880
Fax
Toxanomy
Taxonomy Code 363LP2300X
License State Pennsylvania
License Number SPO13376
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According to our database, Vincent Tyson NPI is 1003245457, taxonomy code is 363LP2300X and license number is SPO13376, license state is located at Pennsylvania. Vincent Tyson physically located at 760 Carpenter Ln, Philadelphia PA, 19119-3406. NPI Number Vincent Tyson has the Individual type.

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1003245457 NPI number is provided on an as is basis without warranty of any kind. 1003245457 is maintained by the National Plan & Provider Enumeration System. The contents of Vincent Tyson are for informational purposes only.