Provider Demographics
NPI:1801164074
Name:SALIM, TAMANNA YUSSOUF (MD)
Entity type:Individual
Prefix:
First Name:TAMANNA
Middle Name:YUSSOUF
Last Name:SALIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMANNA
Other - Middle Name:
Other - Last Name:YUSSOUF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17 LENAPE DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4647
Mailing Address - Country:US
Mailing Address - Phone:908-400-5041
Mailing Address - Fax:
Practice Address - Street 1:17 LENAPE DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4647
Practice Address - Country:US
Practice Address - Phone:908-400-5041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ45280207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine