Provider Demographics
NPI:1922688894
Name:MILLS-TAGOE, HARRIET (APN)
Entity Type:Individual
Prefix:MRS
First Name:HARRIET
Middle Name:
Last Name:MILLS-TAGOE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 YORKSHIRE VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-1326
Mailing Address - Country:US
Mailing Address - Phone:908-451-0557
Mailing Address - Fax:
Practice Address - Street 1:900 WOODBRIDGE CENTER DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1324
Practice Address - Country:US
Practice Address - Phone:732-636-4111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01122100207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease