Individual
TONY PAULINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-8484
Mailing address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
SP035152
PA
363LA2100X
Acute Care Nurse Practitioner
Primary
SP000000
PA
Other
Enumeration date
01/26/2026
Last updated
03/26/2026
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