Individual
MAZELL TETRUASHVILY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5888
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-9664
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
MD480490
PA
Other
Enumeration date
05/17/2018
Last updated
01/22/2025
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