Provider Demographics
NPI:1366644601
Name:KASDAGLIS, TANIA LUNA (MD)
Entity Type:Individual
Prefix:DR
First Name:TANIA
Middle Name:LUNA
Last Name:KASDAGLIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:94 OLD SHORT HILLS RD
Mailing Address - Street 2:EAST WING, SUITE 402
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-5287
Mailing Address - Fax:973-322-2309
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:EAST WING, SUITE 402
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5287
Practice Address - Fax:973-322-2309
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2015-11-12
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08925100207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ226691RJQMedicare UPIN