Individual
TOMA DZOTSENIDZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
31 W ALLENS LN, PHILADELPHIA, PA 19119-1647
(267) 690-0890
Mailing address
10928 NANDINA CT FL 1, PHILADELPHIA, PA 19116-3110
(267) 690-0890
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/20/2026
Last updated
05/20/2026
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