Provider Demographics
NPI:1548338080
Name:TAWDE, DARSHANA P (MD)
Entity type:Individual
Prefix:
First Name:DARSHANA
Middle Name:P
Last Name:TAWDE
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 1:225 MAY ST STE E
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3266
Mailing Address - Country:US
Mailing Address - Phone:732-661-2020
Mailing Address - Fax:732-661-2022
Practice Address - Street 1:225 MAY ST STE E
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3266
Practice Address - Country:US
Practice Address - Phone:732-661-2020
Practice Address - Fax:732-661-2022
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09394600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA138976OtherMEDICARE PTAN
PA102222904Medicaid
PA138976OtherMEDICARE PTAN