Provider Demographics
NPI:1306880943
Name:COHEN-TALLY, TOBY (MD)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:
Last Name:COHEN-TALLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 PINEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1613
Mailing Address - Country:US
Mailing Address - Phone:215-728-7774
Mailing Address - Fax:215-722-3893
Practice Address - Street 1:7500 CENTRAL AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2430
Practice Address - Country:US
Practice Address - Phone:215-728-7774
Practice Address - Fax:215-722-3893
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422059174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist