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General NPI Number Information
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NPI Number | 1164710463
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Entity Type | Individual
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Provider Name | KEVIN TABIJE DO
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Gender | Male
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 459 WATCHUNG AVE
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City | WATCHUNG
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State | NJ
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Zip | 07069-4945
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Country | US
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Telephone | 908-756-2424
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Fax | 908-756-2447
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Provider Business Mailing Address
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Address Line | 10 JOHNSTON DR
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City | WATCHUNG
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State | NJ
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Zip | 07069-4905
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Country | US
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Telephone | 908-756-2424
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Fax | 908-546-7978
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 25MB09740200
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License Number State | NJ
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