Provider Demographics
NPI:1528371457
Name:TANIOUS, MARIZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIZ
Middle Name:
Last Name:TANIOUS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W 64TH ST
Mailing Address - Street 2:40T
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 W 64TH ST
Practice Address - Street 2:40T
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7129
Practice Address - Country:US
Practice Address - Phone:646-596-8785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program