Provider Demographics
NPI:1265540132
Name:JAMES C TASSINI MD PA
Entity type:Organization
Organization Name:JAMES C TASSINI MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:TASSINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-429-3737
Mailing Address - Street 1:101 KINGS HWY W
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-2126
Mailing Address - Country:US
Mailing Address - Phone:856-429-3737
Mailing Address - Fax:856-429-7030
Practice Address - Street 1:101 KINGS HWY W
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-2126
Practice Address - Country:US
Practice Address - Phone:856-429-3737
Practice Address - Fax:856-429-7030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02595100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH047491Medicare ID - Type UnspecifiedGROUP
NJ0756760001Medicare NSC
NJC56158Medicare UPIN