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General NPI Number Information
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NPI Number | 1255422838
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Entity Type | Individual
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Provider Name | PAUL A TAHERI MD
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 333 CEDAR ST OFFICE OF THE DEAN
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City | NEW HAVEN
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State | CT
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Zip | 06510-3206
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Country | US
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Telephone | 203-485-5790
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Fax |
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Provider Business Mailing Address
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Address Line | 333 CEDAR ST P.O. BOX 208055
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City | NEW HAVEN
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State | CT
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Zip | 06510-3206
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Country | US
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Telephone | 203-485-5790
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301064199
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License Number State | MI
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