MEDICARE: DR. TARA HUNGSPRUKE VANHISE D.O.

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
1	207Q00000X	Family Medicine Physician	25MB08328800	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124213418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARA HUNGSPRUKE VANHISE D.O.

Provider Business Mailing Address
First Line	:	1230 PARKWAY AVE
Second Line	:	SUITE 203
City	:	EWING
State	:	NJ
Zip	:	08628-3018
Country	:	US
Telephone Number	:	609-883-5454
Fax Number	:	609-883-2656

Provider Business Practice Location Address
First Line	:	1230 PARKWAY AVE
Second Line	:	SUITE 203
City	:	EWING
State	:	NJ
Zip	:	08628-3018
Country	:	US
Telephone Number	:	609-883-5454
Fax Number	:	609-883-2565

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	04/29/2021

Similar Medicare Providers

1275425951 — WATERSHED MEDICAL EQUIPMENT INC
Practice Location Address:

1230 PARKWAY AVE STE 304B
EWING, NJ
08628-3018

Practice Phone: 609-337-2737
Practice Fax: 609-775-9266

1194715516 — MRS. CAROLYN JEAN GAUKLER MD
Practice Location Address:

1230 PARKWAY AVE , SUITE 203
EWING, NJ
08628-3018

Practice Phone: 609-883-5454
Practice Fax: 609-883-2565

1396708632 — ROBERT P HOGAN D.O. P.C.
Practice Location Address:

1230 PARKWAY AVE STE 203
EWING, NJ
08628-3018

Practice Phone: 609-883-5454
Practice Fax: 609-882-2565

1568411270 — DR. JENNINE C LUTZ O.D
Practice Location Address:

1230 PARKWAY AVE
EWING, NJ
08628-3018

Practice Phone: 609-882-8833
Practice Fax:

1508806951 — DR. JACQUELINE GETTYS M.D.
Practice Location Address:

1230 PARKWAY AVE , SUITE 203
EWING, NJ
08628-3018

Practice Phone: 609-883-5454
Practice Fax: 609-883-2565

1124179411 — MS. ANN T PERRY APN
Practice Location Address:

1230 PARKWAY AVE STE 303
EWING, NJ
08628-3018

Practice Phone: 609-989-9801
Practice Fax:

Directions to “ DR. TARA HUNGSPRUKE VANHISE D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.