MEDICARE: JAMES TACHIBANA D.P.M.

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	213E00000X	Podiatrist	N003495	NY

General Provider Information

NPI Number	:	1659309664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES TACHIBANA D.P.M.

Provider Business Mailing Address
First Line	:	130 E 40TH ST
Second Line	:	SUITE 1200
City	:	NEW YORK
State	:	NY
Zip	:	10016-0941
Country	:	US
Telephone Number	:	212-213-3100
Fax Number	:	212-213-4100

Provider Business Practice Location Address
First Line	:	130 E 40TH ST
Second Line	:	SUITE 1200
City	:	NEW YORK
State	:	NY
Zip	:	10016-0941
Country	:	US
Telephone Number	:	212-213-3100
Fax Number	:	212-213-4100

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	01/28/2022

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