Provider Demographics
NPI:1720015308
Name:TARAS, JOHN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:TARAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1500 MARKET ST
Mailing Address - Street 2:24TH FLOOR-WEST TOWER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2100
Mailing Address - Country:US
Mailing Address - Phone:215-255-3828
Mailing Address - Fax:215-255-3577
Practice Address - Street 1:216-220 N. BROAD STREET
Practice Address - Street 2:2ND FLOOR, FEINSTEIN BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102
Practice Address - Country:US
Practice Address - Phone:215-762-2663
Practice Address - Fax:215-762-4447
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD045154E207XS0106X, 2085R0202X, 2086S0105X, 2251H1200X, 225XH1200X
NJMA054808207XS0106X, 2085R0202X, 2086S0105X, 2251H1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0407110000OtherINDEPENDENCE BLUE CROSS
200023324OtherRAILROAD MEDICARE
PA585172OtherPENNSYLVANIA BLUE SHIELD
F03824Medicare UPIN
PA585172Medicare PIN
NJ754380P56Medicare ID - Type Unspecified