MEDICARE: TAMMOIMA GICHANA

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	1835P1200X	Pharmacotherapy Pharmacist	28RI03901800	NJ
2	183500000X	Pharmacist	28RI03901800	NJ

General Provider Information

NPI Number	:	1881109635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMOIMA GICHANA

Provider Business Mailing Address
First Line	:	34 BRIGHTON AVE APT 2
Second Line	:
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-1230
Country	:	US
Telephone Number	:	201-892-6124
Fax Number	:

Provider Business Practice Location Address
First Line	:	2816 MORRIS AVE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-4849
Country	:	US
Telephone Number	:	201-892-6124
Fax Number	:

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

Provider Enumeration Date	:	12/01/2017
Last Update Date	:	12/01/2017

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Directions to “ TAMMOIMA GICHANA ” Practice Location

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