Provider Demographics
NPI:1417930165
Name:TANEJA, REEMA (MD)
Entity Type:Individual
Prefix:
First Name:REEMA
Middle Name:
Last Name:TANEJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1280 BOARDMAN CANFIELD RD
Mailing Address - Street 2:STE 3
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4073
Mailing Address - Country:US
Mailing Address - Phone:330-726-1900
Mailing Address - Fax:330-726-0843
Practice Address - Street 1:1280 BOARDMAN CANFIELD RD
Practice Address - Street 2:STE 3
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4073
Practice Address - Country:US
Practice Address - Phone:330-726-1900
Practice Address - Fax:330-726-0843
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2010-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35073047T207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110229958OtherRAILROAD MEDICARE
308485OtherUPMC HEALTH PLAN
341973127027OtherCARESOURCE
7934064OtherAETNA
0404237OtherUNITEDHEALTHCARE
OH2133453Medicaid
Q006322BOtherHOMETOWN PPO PLAN
OH000000224286OtherANTHEM BLUE CROSS AND BLUE SHIELD
000000177044OtherUNISON HEALTH PLAN
3418083OtherCIGNA
OHP006827OtherGATEWAY HEALTH PLAN OF OHIO
7934064OtherAETNA
OHP006827OtherGATEWAY HEALTH PLAN OF OHIO
7934064OtherAETNA