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General NPI Number Information
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NPI Number | 1912210535
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Entity Type | Individual
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Provider Name | TIY ADAMS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/24/2010
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 3905 FORD RD
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City | PHILADELPHIA
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State | PA
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Zip | 19131-2824
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Country | US
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Telephone | 215-220-2171
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Fax |
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Provider Business Mailing Address
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Address Line | 6134 WEBSTER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19143-2218
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Country | US
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Telephone | 215-470-4817
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD254525
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD254525
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License Number State | PA
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