MEDICARE: NIRAJ TANKARIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	042653-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	042653-1	OTHER	NY	LICENSE NUMBER

General Provider Information

NPI Number	:	1275010365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIRAJ TANKARIA

Provider Business Mailing Address
First Line	:	NIRAJTANKARIA89@GMAIL.COM
Second Line	:	47 COTTAGE STREET
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306
Country	:	US
Telephone Number	:	551-998-6451
Fax Number	:

Provider Business Practice Location Address
First Line	:	2829 OCEAN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7869
Country	:	US
Telephone Number	:	347-673-6694
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2018
Last Update Date	:	07/23/2018

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Directions to “ NIRAJ TANKARIA ” Practice Location

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