Provider Demographics
NPI:1700052321
Name:WINKFIELD-ROYSTER, TAWANA (MD)
Entity Type:Individual
Prefix:DR
First Name:TAWANA
Middle Name:
Last Name:WINKFIELD-ROYSTER
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 1:4422 3RD AVE
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2545
Mailing Address - Country:US
Mailing Address - Phone:718-960-9331
Mailing Address - Fax:
Practice Address - Street 1:2021 GRAND CONCOURSE
Practice Address - Street 2:UNION COMMUNITY HEALTH CENTER, 2ND FLOOR, PEDIATRICS
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4304
Practice Address - Country:US
Practice Address - Phone:718-220-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-03
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244170208000000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health Worker