Individual
DR. SUPOJ TANCHAJJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
338 COURT ST, BROOKLYN, NY 11231-4334
(718) 748-4603
(718) 625-3189
Mailing address
239 82ND ST, BROOKLYN, NY 11209-3810
(718) 748-4603
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
NY129075
NY
2086S0129X
Vascular Surgery Physician
NY129075
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00487449
—
NY
Enumeration date
09/13/2005
Last updated
08/18/2016
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