1760878342 NPI number — DR. TANIA K SARKARIA MD

Table of content: DR. TANIA K SARKARIA MD (NPI 1760878342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760878342 NPI number — DR. TANIA K SARKARIA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SARKARIA
Provider First Name:
TANIA
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760878342
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 BEAVER MEADOW RD STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWICH
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05055-9305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-698-2003
Provider Business Mailing Address Fax Number:
866-473-0381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11 BEAVER MEADOW RD STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWICH
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05055-9305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-698-2003
Provider Business Practice Location Address Fax Number:
866-473-0381
Provider Enumeration Date:
04/10/2015

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: 2084P0804X , with the licence number:  042.0015012 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1033565 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".