Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 0101050459 | VA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 239943 | NY |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | D0073753 | MD |
NPI | 1396736005 |
---|---|
Provider Name | Anil Taneja |
First Address | Mc Lean, VA 22102-3109 |
Second Address | Mc Lean, VA 22102-3109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 27/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | (02) |