Provider Demographics
NPI:1801094040
Name:TAHIR, IRUM (DC)
Entity type:Individual
Prefix:DR
First Name:IRUM
Middle Name:
Last Name:TAHIR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-1902
Mailing Address - Country:US
Mailing Address - Phone:315-214-8100
Mailing Address - Fax:315-218-7689
Practice Address - Street 1:1732 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-1902
Practice Address - Country:US
Practice Address - Phone:315-214-8100
Practice Address - Fax:315-218-7689
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor