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General NPI Number Information
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NPI Number | 1184799868
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Entity Type | Organization
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Legal Business Name | GABRIEL T TATARIAN, DO, LLC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 1015 CHESTNUT ST STE 918
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City | PHILADELPHIA
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State | PA
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Zip | 19107
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Country | US
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Telephone | 215-922-1801
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 CHESTNUT ST STE 918
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4309
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Country | US
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Telephone | 215-922-1801
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. BRIAN A MORGAN
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Credential |
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Telephone | 215-922-1801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | OS008458L
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License Number State | PA
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