Individual
TAYLOR TERESE GIVNISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3185
(215) 707-1684
Mailing address
3500 N BROAD ST, PHILADELPHIA, PA 19140-4106
(215) 707-2433
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD477819
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2018
Last updated
11/10/2022
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