Individual
YESSENIA LEONOR CABALLERO-TILLERIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 612-4000
Mailing address
2213 AMBER ST, PHILADELPHIA, PA 19125-2017
(410) 303-9665
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA058602
PA
363AS0400X
Surgical Physician Assistant
OA003987
PA
Other
Enumeration date
11/05/2016
Last updated
02/15/2019
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