Basic Information
Provider Information
NPI: 1750909073
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAUQUIR
FirstName: ANOOSHA
MiddleName: MARIA
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20201 LORAIN RD APT 508
Address2:  
City: FAIRVIEW PARK
State: OH
PostalCode: 441263403
CountryCode: US
TelephoneNumber: 2163103785
FaxNumber:  
Practice Location
Address1: 18101 LORAIN AVE
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441115612
CountryCode: US
TelephoneNumber: 2164767000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/13/2020
LastUpdateDate: 07/13/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/13/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X57.249537OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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