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General NPI Number Information
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NPI Number | 1194801308
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Entity Type | Individual
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Provider Name | TANZIA MUSTAFA MD
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 8107 ASTORIA BLVD
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City | EAST ELMHURST
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State | NY
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Zip | 11370
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Country | US
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Telephone | 646-386-6220
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Fax | 917-832-6598
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Provider Business Mailing Address
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Address Line | 2349 81ST ST
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1620
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Country | US
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Telephone | 646-386-6220
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Fax | 917-832-6598
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 230080
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License Number State | NY
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