Healthcare Provider Details

I. General information

NPI: 1518668599
Provider Name (Legal Business Name): TRI-TECH HEALTH PA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N COLUMBUS BLVD APT 707
PHILADELPHIA PA
19106-1458
US

IV. Provider business mailing address

4577 N NOB HILL RD STE 212
SUNRISE FL
33351-4715
US

V. Phone/Fax

Practice location:
  • Phone: 954-821-7576
  • Fax: 954-634-6444
Mailing address:
  • Phone: 954-821-7576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM HOWARD TUSHINSKI
Title or Position: MANAGER
Credential:
Phone: 954-821-7576