Provider Demographics
NPI:1528015351
Name:TASHOLOVA, ALBENA B (MD)
Entity Type:Individual
Prefix:
First Name:ALBENA
Middle Name:B
Last Name:TASHOLOVA
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 1:50 DAYTON LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2859
Mailing Address - Country:US
Mailing Address - Phone:914-739-0087
Mailing Address - Fax:914-737-1714
Practice Address - Street 1:1980 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4144
Practice Address - Country:US
Practice Address - Phone:914-734-3600
Practice Address - Fax:914-734-3601
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA227753208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
112T9E6551Medicare PIN