Provider Demographics
NPI:1659330975
Name:TAITSMAN, JAMES P (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:TAITSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:123 FRANKLIN CORNER RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2526
Mailing Address - Country:US
Mailing Address - Phone:609-896-0707
Mailing Address - Fax:609-896-2227
Practice Address - Street 1:123 FRANKLIN CORNER RD
Practice Address - Street 2:SUITE 114
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2526
Practice Address - Country:US
Practice Address - Phone:609-896-0707
Practice Address - Fax:609-896-2227
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA31703207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0131903Medicaid
NJ571551Medicare PIN
NJ0131903Medicaid