Provider Demographics
NPI:1639379258
Name:KUMARIA, TANYA (MD)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:
Last Name:KUMARIA
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 1:700 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1798
Mailing Address - Country:US
Mailing Address - Phone:866-519-0457
Mailing Address - Fax:570-770-5263
Practice Address - Street 1:1255 S CEDAR CREST BLVD STE 3500
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6385
Practice Address - Country:US
Practice Address - Phone:610-969-0100
Practice Address - Fax:610-969-0101
Is Sole Proprietor?:No
Enumeration Date:2007-07-22
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94564208000000X, 207R00000X
NC201101474208000000X
PAMD447894208000000X, 207RH0002X
NC2011-01474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028181630001Medicaid
PA287160YGDBMedicare PIN