Provider Demographics
NPI:1881180735
Name:GREGORY TAMAGNINI DPM LLC
Entity Type:Organization
Organization Name:GREGORY TAMAGNINI DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TAMAGNINI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-837-8173
Mailing Address - Street 1:195 US HIGHWAY 46 STE 12
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1833
Mailing Address - Country:US
Mailing Address - Phone:973-837-8173
Mailing Address - Fax:973-837-8174
Practice Address - Street 1:195 US HIGHWAY 46 STE 12
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512
Practice Address - Country:US
Practice Address - Phone:973-837-8173
Practice Address - Fax:973-837-8174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00317600213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty