IndividualActive
Mazell Tetruashvily, MD, PHD
NPI 1295225019 · Preventive Medicine/Occupational Environmental Medicine Physician · Philadelphia, PA
Provider details
- NPI number
- 1295225019
- Entity type
- Individual
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD, PHD
- Sex
- Female
- Sole proprietor
- Yes
- License
- MD480490 (PA)
Specialties & taxonomies
- Preventive Medicine/Occupational Environmental Medicine PhysicianPrimary2083P0500XLicense MD480490 (PA)
Allopathic & Osteopathic Physicians
Practice location
3900 Woodland Ave
Philadelphia, PA 19104-4551
Phone: (215) 823-5888
Approximate (ZIP-level) locationGet directions
Mailing address
3400 Spruce St
Philadelphia, PA 19104-4238
Registry dates
- Enumerated
- 2018-05-17
- Last updated
- 2025-01-22
- Certified
- 2025-01-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.