Healthcare Provider Details

I. General information

NPI: 1659013001
Provider Name (Legal Business Name): TANAY BHUPENDRA TAILOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 NEW BERN AVE
RALEIGH NC
27610-1215
US

IV. Provider business mailing address

305 WESTON ESTATES WAY
MORRISVILLE NC
27560-6991
US

V. Phone/Fax

Practice location:
  • Phone: 919-350-8000
  • Fax:
Mailing address:
  • Phone: 919-457-8113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2026-02982
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: