Provider Demographics
NPI:1386643849
Name:MAINKAR, TANUJA A (MD)
Entity Type:Individual
Prefix:
First Name:TANUJA
Middle Name:A
Last Name:MAINKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:68 S. SERVICE RD.
Mailing Address - Street 2:STE 350
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2358
Mailing Address - Country:US
Mailing Address - Phone:516-945-3107
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:4320 SEMINARY RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1535
Practice Address - Country:US
Practice Address - Phone:703-504-3789
Practice Address - Fax:703-504-3556
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101230927207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC022671F89Medicare PIN
H56078Medicare UPIN