Provider Demographics
NPI:1326140013
Name:TANNER, FRITZI ALMA (MD)
Entity Type:Individual
Prefix:DR
First Name:FRITZI
Middle Name:ALMA
Last Name:TANNER
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 1:206 LAUREL HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-3634
Mailing Address - Country:US
Mailing Address - Phone:856-459-2270
Mailing Address - Fax:856-459-9674
Practice Address - Street 1:206 LAUREL HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-3634
Practice Address - Country:US
Practice Address - Phone:856-459-2270
Practice Address - Fax:856-459-9674
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO61584208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics