Individual
TAINE TAYARD PECHET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BLVD FL 1, PHILADELPHIA, PA 19104-5161
(215) 615-5864
(215) 349-8432
Mailing address
3400 CIVIC CENTER BLVD FL 1, PHILADELPHIA, PA 19104-5161
(215) 615-5864
(215) 349-8432
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA07305200
NJ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
25MA07305200
NJ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD073603L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PE1307068
BLUE SHIELD
PA
Enumeration date
06/14/2006
Last updated
10/22/2019
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