1720303639 NPI number — THOMAS DAVID TARITY M.D.

Table of content: THOMAS DAVID TARITY M.D. (NPI 1720303639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720303639 NPI number — THOMAS DAVID TARITY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TARITY
Provider First Name:
THOMAS
Provider Middle Name:
DAVID
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TARITY
Provider Other First Name:
T.
Provider Other Middle Name:
DAVID
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1720303639
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 LIPPINCOTT DRIVE, SUITE 410
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARLTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-355-0340
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
547 NEW ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERS POINT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-927-9200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207XS0114X , with the licence number:  MD474056 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XS0114X , with the licence number: 25MA12441800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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