Individual
DR. NICHOLAS C TENAGLIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
521 PLYMOUTH RD, SUITE 106, PLYMOUTH MEETING, PA 19462-1638
(610) 941-3921
(610) 941-3391
Mailing address
769 GERMANTOWN PIKE, LAFAYETTE HILL, PA 19444-1620
(610) 941-3921
(610) 941-3391
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD008185E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008946730005
—
PA
01
—
047574
TRICARE
PA
01
—
1162670
HIGHMARK BLUE SHIELD
PA
01
—
4536585
AETNA
PA
Enumeration date
05/18/2006
Last updated
07/24/2008
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