Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 25MA07964600 | NJ |
NPI | 1114983756 |
---|---|
Provider Name | Dr. Lloyd Tinianow |
First Address | Wayne, PA 19087-3070 |
Second Address | Stratford, NJ 08084-1327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2006 |
Last Update Date | 08/07/2007 |