Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 35068088 | OH |
Y | 207QA0505X | Family Doctor - Adult Medicine | 35068088 | OH |
NPI | 1174529861 |
---|---|
Provider Name | Farzana N Tausif |
First Address | Toledo, OH 43604-1558 |
Second Address | Sylvania, OH 43560-2146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 05/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0226464 | (05) | OH |
1174529861 | (05) | MI |
3171933 | CIGNA (01) | OH |
5767102 | AETNA (01) | OH |
G21907 | (02) | OH |