Provider Demographics
NPI:1588031389
Name:TAHA ONCOLOGY PC
Entity type:Organization
Organization Name:TAHA ONCOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HESHAM
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:TAHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-557-1583
Mailing Address - Street 1:568B BUCHANAN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4160
Mailing Address - Country:US
Mailing Address - Phone:516-557-1583
Mailing Address - Fax:718-240-6516
Practice Address - Street 1:568B BUCHANAN AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4160
Practice Address - Country:US
Practice Address - Phone:516-557-1583
Practice Address - Fax:718-240-6516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217791207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty