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General NPI Number Information
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NPI Number | 1063855435
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Entity Type | Organization
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Legal Business Name | TIGA PEDIATRICS PC
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Dates
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Enumeration Date | 04/16/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 3510 BAINBRIDGE AVE S5
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City | BRONX
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State | NY
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Zip | 10467-1409
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Country | US
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Telephone | 718-881-8999
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Fax | 718-881-1984
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Provider Business Mailing Address
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Address Line | PO BOX 672170
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City | BRONX
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State | NY
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Zip | 10467-0803
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Country | US
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Telephone | 718-881-8999
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Fax | 718-881-1984
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Authorized Official
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Title or Position | OWNER
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Name | TOSAN ORUWARIYE
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Credential | M.D.
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Telephone | 718-881-8999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 209367
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License Number State | NY
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