Provider Demographics
NPI:1225243009
Name:SCURRY, TANYA (MD)
Entity type:Individual
Prefix:DR
First Name:TANYA
Middle Name:
Last Name:SCURRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11251 SIERRA AVE # 2E-435
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337-7599
Mailing Address - Country:US
Mailing Address - Phone:909-855-4276
Mailing Address - Fax:909-354-3173
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-020662084P0800X
PAMD4633202084P0800X, 2084P0802X
MS242572084P0800X
MI43011172512084P0800X, 2084P0802X
CAA1047222084P0800X, 2084P0802X
TN646042084P0800X
ARE-149572084P0800X
IL0361521852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry