Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | ME94384 | FL |
NPI | 1417096165 |
---|---|
Provider Name | Nishin S Tambay |
First Address | Clearwater, FL 33756-3398 |
Second Address | Clearwater, FL 33756-3398 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 30/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003882400 | (05) | FL |
G87058 | (02) |