Healthcare Provider Details

I. General information

NPI: 1881679272
Provider Name (Legal Business Name): DAVID NEAL TACHNA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 02/14/2020
Certification Date: 02/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 E HAVERFORD RD FL 3
BRYN MAWR PA
19010-3838
US

IV. Provider business mailing address

931 E HAVERFORD RD FL 3
BRYN MAWR PA
19010-3838
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-5040
  • Fax: 610-642-5042
Mailing address:
  • Phone: 610-642-5040
  • Fax: 610-642-5042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number202
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC004259L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: