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Provider Information for 1386645125

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

GARY TATZ MD

Gender: MALE

Individual NPI: 1386645125

Calendar   Last Updated:  2008-09-29
  Certification Date: 

Details

Name Value
NPI 1386645125
Enumeration Date 2005-08-02
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 95 GRASSLANDS RD
VALHALLA, NY 10595-1533
United States

Phone: 914-493-7513 | Fax: 914-493-1281
View Map External Link
Primary Practice Address 95 GRASSLANDS RD
VALHALLA, NY 10595-1646
United States

Phone: 914-493-7513 | Fax: 914-493-1281
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID NY 02206031
MEDICAID CT 003138329
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2080P0203X - Pediatrics Pediatric Critical Care Medicine NY 220542