Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 0101243007 | VA |
N | 207Q00000X | Family Doctor | 25MA08428700 | NJ |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 25MA08428700 | NJ |
NPI | 1326201815 |
---|---|
Provider Name | Arash Tadbiri |
First Address | Hyannis, MA 02601-3644 |
Second Address | Bourne, MA 02532-3659 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2008 |
Last Update Date | 14/06/2019 |