Individual
JED TANADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-5506
Mailing address
7215 E PAMPA AVE, MESA, AZ 85212-9792
(480) 678-0524
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
320694-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2020
Last updated
04/11/2024
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