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General NPI Number Information
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NPI Number | 1922024173
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Entity Type | Organization
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Legal Business Name | TIZIANA PENSABENI JASPER,MD LLC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 1135 CLIFTON AVE SUITE #102
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City | CLIFTON
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State | NJ
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Zip | 07013-3642
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Country | US
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Telephone | 973-778-4440
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Fax | 973-778-4427
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Provider Business Mailing Address
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Address Line | 1135 CLIFTON AVE SUITE #102
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City | CLIFTON
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State | NJ
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Zip | 07013-3642
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Country | US
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Telephone | 973-778-4440
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Fax | 973-778-4427
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Authorized Official
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Title or Position | MD
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Name | DR. TIZIANA PENSABENI JASPER
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Credential | MD
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Telephone | 973-778-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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