MEDICARE: NIRMAL TEJWANI 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
1	207X00000X	Orthopaedic Surgery Physician	214945	NY

General Provider Information

NPI Number	:	1417943820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIRMAL TEJWANI M.D.

Provider Business Mailing Address
First Line	:	303 2ND AVE
Second Line	:	SUITE 21
City	:	NEW YORK
State	:	NY
Zip	:	10003-2739
Country	:	US
Telephone Number	:	212-598-6573
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 2ND AVE
Second Line	:	SUITE 21
City	:	NEW YORK
State	:	NY
Zip	:	10003-2739
Country	:	US
Telephone Number	:	212-598-6573
Fax Number	:

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	08/06/2012

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