Individual provider · Type 1 NPI
Kimberly D. Tankasali, PA-C
Medical Physician Assistant · Pompton Plains, NJ
NPI number
1417061870
Active
Practice location
97 W Parkway
Pompton Plains, NJ 07444-1647
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | 010698 (NY) |
| Medical Physician Assistant Primary | 363AM0700X | 25MP00145300 (NJ) |
Medical Physician Assistant: Definition to come...
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About NPI 1417061870
Kimberly D. Tankasali, PA-C's National Provider Identifier is 1417061870, issued on Aug 19, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Pompton Plains, NJ. The record was last updated on Oct 2, 2012.