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General NPI Number Information
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NPI Number | 1649692500
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Entity Type | Organization
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Legal Business Name | DR. JOHN TRZESNIOWSKI LLC
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 01/16/2014
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Provider Practice Location Address
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Address Line | 2716 E ALLEGHENY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-5916
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Country | US
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Telephone | 215-426-3610
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Fax | 215-426-6835
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Provider Business Mailing Address
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Address Line | 2716 E ALLEGHENY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-5916
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Country | US
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Telephone | 215-426-3610
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Fax | 215-426-6835
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOHN G TRZESNIOWSKI
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Credential | D.O.
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Telephone | 215-426-3610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS016628
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS003175L
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License Number State | PA
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