Organization
TPS II OF PA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE HAYNES (MANAGER)
(215) 762-4312
Entity
Organization
Contact information
Practice address
245 N BROAD ST, MS 310, PHILA, PA 19107-1518
(215) 762-4312
Mailing address
245 N. BROAD ST, MS 310, PHILA, PA 19102
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012189070001
—
PA
Enumeration date
05/05/2006
Last updated
08/22/2020
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