Individual
DR. IRA A. TABAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2068
Mailing address
630 W 168TH ST # 4, VC 12TH FLOOR, SUITE 208, NEW YORK, NY 10032-3725
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
150522
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00881356
—
NY
Enumeration date
01/04/2007
Last updated
07/08/2007
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