Provider Demographics
NPI:1568620300
Name:TAI, TAK YEE TANIA (MD)
Entity Type:Individual
Prefix:
First Name:TAK YEE TANIA
Middle Name:
Last Name:TAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 EAST 14TH STREET
Mailing Address - Street 2:SUITE 319S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4210
Mailing Address - Country:US
Mailing Address - Phone:212-979-4500
Mailing Address - Fax:212-979-4512
Practice Address - Street 1:310 EAST 14TH STREET
Practice Address - Street 2:SUITE 319S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4210
Practice Address - Country:US
Practice Address - Phone:212-979-4500
Practice Address - Fax:212-979-4512
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98402207W00000X
PAMD436287207W00000X
NY257879207W00000X
NYA257879207W00000X, 207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology