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General NPI Number Information
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NPI Number | 1154541027
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Entity Type | Individual
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Provider Name | ALEXANDER TARNOPOLSKY D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14200 BUSTLETON AVE SUITE 4
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City | PHILADELPHIA
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State | PA
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Zip | 19116-1186
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Country | US
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Telephone | 215-671-0900
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Fax | 215-671-8114
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Provider Business Mailing Address
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Address Line | 9963 WINGTIP RD
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City | PHILADELPHIA
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State | PA
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Zip | 19115-1708
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Country | US
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Telephone | 215-533-4906
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS010564L
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License Number State | PA
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