Healthcare Provider Details

I. General information

NPI: 1336274935
Provider Name (Legal Business Name): FLOYD R. TANZER, M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 11/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

992 CLIFTON AVE
CLIFTON NJ
07013-3502
US

IV. Provider business mailing address

992 CLIFTON AVE
CLIFTON NJ
07013-3502
US

V. Phone/Fax

Practice location:
  • Phone: 973-365-1800
  • Fax: 973-777-0380
Mailing address:
  • Phone: 973-365-1800
  • Fax: 973-777-0380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA02898500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number25MA02898500
License Number StateNJ

VIII. Authorized Official

Name: DR. FLOYD RICHARD TANZER
Title or Position: PRESIDENT
Credential: MD
Phone: 973-365-1800