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Contact Information

TITO K MANTILLA, MD
5501 OLD YORK RD STE 1
PHILADELPHIA, PA19141
 Phone: 215-456-7890
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for TITO K MANTILLA · (Male)

NPI # 1205498318
Status Active
Credentials MD
Entity Individual
Enumeration date 06/28/2019
Last updated 09/15/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • PA License # MD478971
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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