Provider Demographics
NPI:1164492880
Name:LAKHANI, TASNEEM (MD)
Entity Type:Individual
Prefix:
First Name:TASNEEM
Middle Name:
Last Name:LAKHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:25 MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1296
Mailing Address - Country:US
Mailing Address - Phone:410-526-8310
Mailing Address - Fax:410-526-8316
Practice Address - Street 1:2835 SMITH AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-1453
Practice Address - Country:US
Practice Address - Phone:410-526-8310
Practice Address - Fax:443-548-5705
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0028595207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD341311000Medicaid
B70364Medicare UPIN
MDH348I458Medicare ID - Type Unspecified