Provider Demographics
NPI:1922031046
Name:TAYOUN, PAUL JAMES (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:JAMES
Last Name:TAYOUN
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 1:622 W 168 ST
Mailing Address - Street 2:PH 1-137
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3784
Mailing Address - Country:US
Mailing Address - Phone:212-305-2995
Mailing Address - Fax:212-305-6792
Practice Address - Street 1:2171 ROUTE 70 W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2733
Practice Address - Country:US
Practice Address - Phone:856-406-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2022-09-08
Deactivation Date:2006-07-19
Deactivation Code:
Reactivation Date:2006-10-24
Provider Licenses
StateLicense IDTaxonomies
NY206451207P00000X
NJ25MA08822200207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G66732Medicare UPIN