Healthcare Provider Details

I. General information

NPI: 1689505497
Provider Name (Legal Business Name): TIJANKA WHALEY LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: IJADADA WHALEY CRANIAL PROSTETHICS

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 HORSHAM RD UNIT 839
HORSHAM PA
19044-1795
US

IV. Provider business mailing address

575 HORSHAM RD UNIT 839
HORSHAM PA
19044-1795
US

V. Phone/Fax

Practice location:
  • Phone: 215-519-1000
  • Fax: 412-866-3300
Mailing address:
  • Phone: 215-519-1000
  • Fax: 412-866-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: