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Individual

DR. JOSE MARTIN TAVERAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(917) 847-0981
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(917) 847-0981

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
253121
NY
207RC0000X
Cardiovascular Disease Physician
Primary
253121
NY

Other

Enumeration date
01/02/2009
Last updated
02/24/2021
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