Individual
DR. SAMIR S TILAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
748 KINGS HWY, WOODBURY, NJ 08096-3157
(856) 848-4998
(856) 848-9288
Mailing address
1307 WHITE HORSE RD, SUITE A-102, VOORHEES, NJ 08043-2176
(856) 374-4031
(856) 784-6307
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA07237300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8539502
—
NJ
Enumeration date
03/31/2006
Last updated
01/22/2015
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