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General NPI Number Information
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NPI Number | 1477180479
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Entity Type | Organization
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Legal Business Name | TAJ MEDICAL PLLC
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 10925 111TH ST
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City | SOUTH OZONE PARK
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State | NY
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Zip | 11420-1015
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Country | US
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Telephone | 347-385-6059
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Fax |
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Provider Business Mailing Address
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Address Line | 10923 111TH ST
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City | SOUTH OZONE PARK
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State | NY
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Zip | 11420-1015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAJDHARY TIWARI
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Credential | MD
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Telephone | 347-385-6059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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