MEDICARE: DR. AURORA TOMPAR TIU 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	2084P0804X	Child & Adolescent Psychiatry Physician	213505	NY

General Provider Information

NPI Number	:	1750553301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AURORA TOMPAR TIU M.D.

Provider Business Mailing Address
First Line	:	3510 BAINBRIDGE AVE
Second Line	:	SUITE S1
City	:	BRONX
State	:	NY
Zip	:	10467-1409
Country	:	US
Telephone Number	:	917-930-2128
Fax Number	:	201-357-4163

Provider Business Practice Location Address
First Line	:	3510 BAINBRIDGE AVE
Second Line	:	SUITE S1
City	:	BRONX
State	:	NY
Zip	:	10467-1409
Country	:	US
Telephone Number	:	917-930-2128
Fax Number	:	201-357-4163

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

Provider Enumeration Date	:	03/24/2008
Last Update Date	:	03/24/2008

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