Provider Demographics
NPI:1790049864
Name:DILOACH, TITANYA
Entity Type:Individual
Prefix:MS
First Name:TITANYA
Middle Name:
Last Name:DILOACH
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 1:140 ALCOTT PL
Mailing Address - Street 2:# 29-G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4302
Mailing Address - Country:US
Mailing Address - Phone:347-499-9715
Mailing Address - Fax:
Practice Address - Street 1:140 ALCOTT PL
Practice Address - Street 2:# 29-G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4302
Practice Address - Country:US
Practice Address - Phone:347-499-9715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist