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General NPI Number Information
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NPI Number | 1487772083
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Entity Type | Organization
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Legal Business Name | MANISH TANDON, MD,ASSOCIATES PC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/21/2009
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Provider Practice Location Address
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Address Line | 300 MOUNT AUBURN ST SUITE 406
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City | CAMBRIDGE
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State | MA
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Zip | 02138-5600
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Country | US
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Telephone | 617-562-0500
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Fax | 617-562-0600
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Provider Business Mailing Address
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Address Line | 300 MOUNT AUBURN ST SUITE 406
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City | CAMBRIDGE
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State | MA
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Zip | 02138-5600
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Country | US
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Telephone | 617-562-0500
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Fax | 617-562-0600
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Authorized Official
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Title or Position | DOCTOR
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Name | MANISH TANDON
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Credential | M.D., P.C.
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Telephone | 617-562-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 115573
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License Number State | MA
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