Provider Demographics
NPI:1114448149
Name:SIDHU, TAHNEE KAUR (MD)
Entity Type:Individual
Prefix:
First Name:TAHNEE
Middle Name:KAUR
Last Name:SIDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CAMBRIDGE STREET
Mailing Address - Street 2:INTERNAL MEDICINE RESIDENCY PROGRAM
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2907
Mailing Address - Country:US
Mailing Address - Phone:617-789-3000
Mailing Address - Fax:
Practice Address - Street 1:736 CAMBRIDGE STREET
Practice Address - Street 2:ST. ELIZABETH'S MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-789-2386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA272823207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology