Individual
TIANA MARIE ACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(800) 836-7536
Mailing address
315 N 12TH ST APT 615, PHILADELPHIA, PA 19107-1222
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MT229303
PA
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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