Provider Demographics
NPI:1639326739
Name:DUNCOMBE, TAJI R
Entity Type:Individual
Prefix:
First Name:TAJI
Middle Name:R
Last Name:DUNCOMBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3757
Mailing Address - Country:US
Mailing Address - Phone:718-442-7828
Mailing Address - Fax:718-720-0762
Practice Address - Street 1:77 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3757
Practice Address - Country:US
Practice Address - Phone:718-442-7828
Practice Address - Fax:718-720-0762
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical