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General NPI Number Information
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NPI Number | 1154366805
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Entity Type | Individual
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Provider Name | TANISHA KADENE TAYLOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 832 BRUNSWICK AVE
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City | TRENTON
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State | NJ
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Zip | 08638-3829
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Country | US
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Telephone | 609-695-7471
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Fax | 609-393-5272
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Provider Business Mailing Address
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Address Line | 832 BRUNSWICK AVE
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City | TRENTON
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State | NJ
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Zip | 08638-3829
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Country | US
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Telephone | 609-695-7471
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Fax | 609-393-5272
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 042698
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 5MA08113000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5MA08113000
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License Number State | NJ
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