Individual
TINA CHEMPLAYIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-3375
(215) 707-4758
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3375
(215) 707-4758
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP017145
PA
363LF0000X
Family Nurse Practitioner
SP017145
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP017145
UROLOGY
PA
Enumeration date
08/22/2017
Last updated
02/18/2025
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