Provider Demographics
NPI:1235239013
Name:TAMMANA, SWARNA (DO)
Entity Type:Individual
Prefix:DR
First Name:SWARNA
Middle Name:
Last Name:TAMMANA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 STATE ROUTE 31
Mailing Address - Street 2:STE 111
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4953
Mailing Address - Country:US
Mailing Address - Phone:908-284-9880
Mailing Address - Fax:908-782-4316
Practice Address - Street 1:111 STATE ROUTE 31
Practice Address - Street 2:STE 111
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4953
Practice Address - Country:US
Practice Address - Phone:908-284-9880
Practice Address - Fax:908-782-4316
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09920500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD149476YBDBMedicare PIN
H03411Medicare UPIN
018507M86Medicare ID - Type Unspecified