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NPI Code Detail

MEDICARE: TYWANYA NHAWAY

MEDICARE: TYWANYA NHAWAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171W00000XContractor

General Provider Information

NPI Number : 1962643908
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYWANYA NHAWAY
Provider Business Mailing Address
First Line : 3414 W WESTMORELAND ST
Second Line : 3RD FLR
City : PHILADELPHIA
State : PA
Zip : 19129-1223
Country : US
Telephone Number : 267-407-6467
Fax Number :
Provider Business Practice Location Address
First Line : 3414 W WESTMORELAND ST
Second Line : 3RD FLR
City : PHILADELPHIA
State : PA
Zip : 19129-1223
Country : US
Telephone Number : 267-407-6467
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2009
Last Update Date : 03/22/2009

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Directions to “ TYWANYA NHAWAY ” Practice Location

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