Individual
DR. MAHIRA TANOVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 MARCUS AVENUE, SUITE, 103, LAKE SUCCESS, NY 11042-1018
(516) 354-1330
(516) 775-5953
Mailing address
2500 MARCUS AVENUE, SUITE, 103, LAKE SUCCESS, NY 11042-1018
(516) 354-1330
(516) 775-5953
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
230867
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230867
LICENSE
NY
Enumeration date
11/04/2006
Last updated
03/07/2023
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