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Individual

DONALD N TAVAKOLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
191 PRESIDENTIAL BLVD, SUITE C132, BALA CYNWYD, PA 19004-1207
(610) 664-5182
Mailing address
191 PRESIDENTIAL BLVD, SUITE C132, BALA CYNWYD, PA 19004-1207
(610) 664-5182

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD432154
PA

Other

Enumeration date
12/29/2006
Last updated
07/30/2012
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