Provider Demographics
NPI:1437551272
Name:TALL, ABDULIA (MPA)
Entity Type:Individual
Prefix:
First Name:ABDULIA
Middle Name:
Last Name:TALL
Suffix:
Gender:M
Credentials:MPA
Other - Prefix:
Other - First Name:FIRST CHOICE HOME &
Other - Middle Name:COMMUNITY
Other - Last Name:SERVICES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SCO
Mailing Address - Street 1:520 PUSEY AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19023-3300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 PUSEY AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:COLLINGDALE
Practice Address - State:PA
Practice Address - Zip Code:19023-3300
Practice Address - Country:US
Practice Address - Phone:267-391-5290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator