Individual
DR. TANYA M DOUGHERTY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
BS, PHARMD, BCPS
Contact information
Practice address
51 N 39TH ST, 6TH FLOOR MUTCH BUILDING, PHILADELPHIA, PA 19104-2640
(215) 662-8933
Mailing address
51 N 39TH ST, 6TH FLOOR MUTCH BUILDING, PHILADELPHIA, PA 19104-2640
(215) 662-8933
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
RP044507L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012139830001
—
PA
Enumeration date
07/05/2005
Last updated
07/09/2007
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