Dougherty, Tanya M

Dougherty, Tanya M is an individual health care provider with primary practice located at 51 N 39Th St 6Th Floor Mutch Building, Philadelphia PA 19104-2640. She recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as her primary health care specialty. Dougherty, Tanya M can be contacted via phone (215) 662-8933.

Contact Information

Primary practice address
51 N 39Th St 6Th Floor Mutch Building Philadelphia PA 19104-2640
Phone: (215) 662-8933
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacotherapy 1835P1200X RP044507L Pennsylvania

Profile Details

NPI number 1679570733
LBN Legal business name Dougherty, Tanya M
Credentials BS, PHARMD, BCPS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679570733 NPPES
Pennsylvania MEDICAID 1012139830001

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