Healthcare Provider Details

I. General information

NPI: 1639379258
Provider Name (Legal Business Name): TANYA KUMARIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2007
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 S CEDAR CREST BLVD STE 3500
ALLENTOWN PA
18103-6385
US

IV. Provider business mailing address

700 QUINCY AVE
SCRANTON PA
18510-1798
US

V. Phone/Fax

Practice location:
  • Phone: 610-969-0100
  • Fax: 610-969-0101
Mailing address:
  • Phone: 866-519-0457
  • Fax: 570-770-5263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA94564
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number201101474
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD447894
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberMD447894
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA94564
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2011-01474
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: