Individual
INDIRA TATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
97 W PARKWAY, POMPTON PLAINS, NJ 07444-1647
(973) 831-5000
(973) 831-5432
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA12152000
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2021
Last updated
10/08/2024
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