Provider Demographics
NPI:1457019614
Name:TILGHMAN, QUIANA
Entity Type:Individual
Prefix:
First Name:QUIANA
Middle Name:
Last Name:TILGHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 N MARSTON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-3536
Mailing Address - Country:US
Mailing Address - Phone:267-969-8458
Mailing Address - Fax:
Practice Address - Street 1:2502 N MARSTON ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-3536
Practice Address - Country:US
Practice Address - Phone:267-969-8458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist