Individual
DR. VINCENT N TISA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2401 S BROAD ST, PHILADELPHIA, PA 19148-3508
(215) 389-7774
(215) 389-0443
Mailing address
2401 S BROAD ST, PHILADELPHIA, PA 19148-3508
(215) 389-7774
(215) 389-0443
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC001399L
PA
Other
Enumeration date
06/06/2006
Last updated
04/20/2016
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