Healthcare Provider Details

I. General information

NPI: 1831061712
Provider Name (Legal Business Name): KENDRA TANWIR DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2025
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 RAHWAY AVE FL 1
UNION NJ
07083-6634
US

IV. Provider business mailing address

700 RAHWAY AVE FL 1
UNION NJ
07083-6634
US

V. Phone/Fax

Practice location:
  • Phone: 908-451-3544
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15359300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: