Dougherty, Tanya M
Dougherty, Tanya M is an individual health care provider with primary practice located at 51 N 39Th St 6Th Floor Mutch Building, Philadelphia PA 19104-2640. She recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as her primary health care specialty. Dougherty, Tanya M can be contacted via phone (215) 662-8933.Contact Information
Primary practice address
51 N 39Th St 6Th Floor Mutch Building
Philadelphia PA 19104-2640
Phone: (215) 662-8933
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacotherapy | 1835P1200X | RP044507L | Pennsylvania |
Profile Details
| NPI number | 1679570733 |
|---|---|
| LBN Legal business name | Dougherty, Tanya M |
| Credentials | BS, PHARMD, BCPS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2005 |
| Last updated | Jul 9th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679570733 | NPPES |
| Pennsylvania | MEDICAID | 1012139830001 |
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