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NPI Code Detail

MEDICARE: DR. LAUREN ANNE TARNOK M.D.

MEDICARE: DR. LAUREN ANNE TARNOK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0006XDevelopmental - Behavioral Pediatrics Physician25MA10467900NJ
22080P0006XDevelopmental - Behavioral Pediatrics Physician262113NY

General Provider Information

NPI Number : 1053698274
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAUREN ANNE TARNOK M.D.
Provider Business Mailing Address
First Line : 2840 MORRIS AVE
Second Line :
City : UNION
State : NJ
Zip : 07083-4851
Country : US
Telephone Number : 888-244-5373
Fax Number : 908-686-3024
Provider Business Practice Location Address
First Line : 2840 MORRIS AVE
Second Line :
City : UNION
State : NJ
Zip : 07083-4851
Country : US
Telephone Number : 888-244-5373
Fax Number : 908-686-3024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2011
Last Update Date : 01/20/2022

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