Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 32277 | NY |
NPI | 1174576250 |
---|---|
Provider Name | Dr. Jeffrey Leon Tarlow |
First Address | Westfield, NJ 07090-3434 |
Second Address | New York, NY 10010-5011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 08/07/2007 |