MEDICARE: DR. TARYN V TAPIA O.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	152W00000X	Optometrist	270A00574100	NJ

General Provider Information

NPI Number	:	1497772420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARYN V TAPIA O.D.

Provider Business Mailing Address
First Line	:	PO BOX 4112
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07012-8112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	543 RIVER RD
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1146
Country	:	US
Telephone Number	:	201-941-7331
Fax Number	:

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	01/22/2008

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