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General NPI Number Information
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NPI Number | 1831037423
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Entity Type | Individual
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Provider Name | TANIYAH LYNNAE DUBOSE
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Gender | Female
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 73 AMBOY AVE
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City | METUCHEN
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State | NJ
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Zip | 08840-2549
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Country | US
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Telephone | 848-365-4030
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Fax |
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Provider Business Mailing Address
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Address Line | 831 W 8TH ST
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City | PLAINFIELD
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State | NJ
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Zip | 07063-1539
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Country | US
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Telephone | 929-379-3680
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 18KT01563900
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License Number State | NJ
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