Provider Demographics
NPI:1780687228
Name:TANZER, FLOYD RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:RICHARD
Last Name:TANZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:992 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3502
Mailing Address - Country:US
Mailing Address - Phone:973-365-1800
Mailing Address - Fax:973-777-0380
Practice Address - Street 1:992 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3502
Practice Address - Country:US
Practice Address - Phone:973-365-1800
Practice Address - Fax:973-777-0380
Is Sole Proprietor?:No
Enumeration Date:2005-05-28
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02898500207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1328107Medicaid
NJTA459768Medicare ID - Type Unspecified
NJ1328107Medicaid