Individual
JUDITH ANN TANENBAUM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2100 W GIRARD AVE, PHILA, PA 19130
(215) 214-1094
(215) 214-1098
Mailing address
623 UNRUH AVE, 2ND FL, PHILA, PA 19111
(215) 214-1094
(215) 214-1098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA002088L
PA
Other
Enumeration date
12/27/2005
Last updated
07/08/2007
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