Provider Demographics
NPI:1184769895
Name:TANEJA, LOVELINA (MD)
Entity type:Individual
Prefix:
First Name:LOVELINA
Middle Name:
Last Name:TANEJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:460 TOTTEN POND RD
Mailing Address - Street 2:CO MZI
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1906
Mailing Address - Country:US
Mailing Address - Phone:781-890-9933
Mailing Address - Fax:781-890-9950
Practice Address - Street 1:33 EDGELL RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701
Practice Address - Country:US
Practice Address - Phone:508-620-6615
Practice Address - Fax:508-879-1597
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA150404208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA250404OtherTUFTS
MAJ16987OtherBCBS
MA201411OtherHPHC
MA3156991Medicaid