Provider Demographics
NPI:1336750371
Name:TIBB HEALTHCARE ASSOCIATES
Entity Type:Organization
Organization Name:TIBB HEALTHCARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:TIBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-500-7126
Mailing Address - Street 1:12 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1009
Mailing Address - Country:US
Mailing Address - Phone:201-500-7126
Mailing Address - Fax:984-220-9451
Practice Address - Street 1:197 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4317
Practice Address - Country:US
Practice Address - Phone:201-500-7126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty