Organization
TARA LYN CUDA, D.O., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA LYN CUDA D.O. (PRESIDENT)
(215) 334-3869
Entity
Organization
Contact information
Practice address
2230 S BROAD ST, PHILADELPHIA, PA 19145-3950
(215) 334-3869
(215) 755-3300
Mailing address
2230 S BROAD ST, PHILADELPHIA, PA 19145-3950
(215) 334-3869
(215) 755-3300
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2038856
HBS
PA
Enumeration date
02/20/2009
Last updated
02/20/2009
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