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TISA ALEXIS TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4510 FRANKFORD AVE, PHILADELPHIA, PA 19124-3602
(215) 744-1302
(215) 744-2544
Mailing address
432 N 6TH ST, PHILA, PA 19123-4004
(215) 925-2400
(215) 925-9162

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD440235
PA
208000000X
Pediatrics Physician
MT191370
PA

Other

Enumeration date
05/27/2008
Last updated
06/25/2010
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