Basic Information
| Provider Information | |||||||||
| NPI: | 1144410390 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TATAR | ||||||||
| FirstName: | EMILIANO | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | TATAR | ||||||||
| OtherFirstName: | EMILIANO | ||||||||
| OtherMiddleName: | AMIR | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 191 | ||||||||
| Address2: | |||||||||
| City: | ROCKLAND | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197320191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026514000 | ||||||||
| FaxNumber: | 3026514945 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 W LANCASTER AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | WAYNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190874061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102932229 | ||||||||
| FaxNumber: | 6102932231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD431851 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208D00000X | MD431851 | PA | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.