Provider Demographics
NPI:1760532873
Name:TILSON-CHRYSLER, ARLENE (DC)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:
Last Name:TILSON-CHRYSLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7622 OGONTZ AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-1817
Mailing Address - Country:US
Mailing Address - Phone:215-224-8980
Mailing Address - Fax:
Practice Address - Street 1:7622 OGONTZ AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-1817
Practice Address - Country:US
Practice Address - Phone:215-224-8980
Practice Address - Fax:215-224-9342
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-006238111N00000X
NYX011255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000809226Medicare ID - Type Unspecified
PA000809226Medicare PIN