TAHIRA F MIRZA (NPI# 1063690691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063690691 |
| Entity Type | Individual |
| Full Name | TAHIRA F MIRZA |
| Credential | M.D. |
| Practice Address |
707 E Main St Middletown NY 10940-2650 |
| Practice Telephone | 8453337575 |
| Practice Fax Number | 8453331343 |
| Mailing Telephone | 8453337575 |
| Mailing Fax Number | 8453331343 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2018-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 036-119777 | IL | Allopathic & Osteopathic Physicians |
| Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
291600 | NY | Allopathic & Osteopathic Physicians |
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
4301072064 | MI | Allopathic & Osteopathic Physicians |
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
042481 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036119777 | 05 | |
| CT | PENDING | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 68 Harris Bushville Rd, Harris, NY 12742 | 8457940996 | 8457943347 |
| 80 Seymour St, Hartford Hospital Trauma Dept, Hartford, CT 061028000 | 8605453112 |
| Street Address |
707 E MAIN ST |
| City | MIDDLETOWN |
| State | NY |
| Zip Code | 10940-2650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649275942 | Mihai Olteanu | Anesthesiology | 707 E Main St, Middletown, NY 10940 | 2005-06-15 |
| 1699373944 | Cara Maher | Speech-Language Pathologist | 707 E Main St, Middletown, NY 10940-2650 | 2020-10-09 |
| 1396358552 | Rachel Chassen | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2020-08-27 |
| 1942812623 | Priyanka Tadepalli | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2020-08-23 |
| 1447868807 | Jennifer Marie Wade | Physician Assistant | 707 E Main St, Middletown, NY 10940-2650 | 2020-07-21 |
| 1558989004 | Anisha Vadehra | Physician Assistant | 707 E Main St, Middletown, NY 10940-2650 | 2020-07-10 |
| 1740805464 | Zahid Mahmood | Student in an Organized Health Care Education/Training Program | 707 E Main St, Middletown, NY 10940-2650 | 2020-06-09 |
| 1780209338 | Umbreen Ahmad | Student in an Organized Health Care Education/Training Program | 707 E Main St, Middletown, NY 10940-2650 | 2020-06-09 |
| 1306460100 | Manal Saif | Student in an Organized Health Care Education/Training Program | 707 E Main St, Middletown, NY 10940-2650 | 2020-06-08 |
| 1083238984 | Arezoo Teimouri | Physician Assistant | 707 E Main St, Middletown, NY 10940-2650 | 2020-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366043135 | Sherell Rebecca Hassell-robinson | Social Worker | 1 Echo Hills Road, Middletown, NY 10940 | 2020-11-06 |
| 1144821927 | Fred Allen Mccormack | Social Worker | 210 East Main St Suite 105, Middletown, NY 10940 | 2020-11-06 |
| 1609484567 | Gen Med Inc | Anesthesiology | 253 Route 211 East, 2nd Floor, Middletown, NY 10940 | 2020-07-16 |
| 1366067092 | Kalyn Ruscher | Counselor | 303 5th Ave 14 Fl, Suite 1410, New York, NY 10940 | 2020-06-09 |
| 1780238220 | Angela Mayo | Social Worker | 24 Union Street, Middletown, NY 10940 | 2019-08-01 |
| 1215593611 | Northern Medical Center, Inc | Family Medicine | 14 Jason Place, Suite 201, Middletown, NY 10940 | 2019-05-13 |
| 1811468267 | Diana Katzenberger | Licensed Practical Nurse | 774 Kurbytuwn Rd, Middletown, NY 10940 | 2018-12-11 |
| 1881165330 | Chereen Madden-grant | Registered Nurse | 1028 Route 211 W, Middletown, NY 10940 | 2018-12-10 |
| 1184106361 | Clarise Denise Williams | Social Worker | 210 E Main St Suite 105, Middletown, NY 10940 | 2018-09-04 |
| 1194210963 | Damon Tremayne Swinea | Social Worker | 16-24 Union St., Middletown, NY 10940 | 2018-06-25 |
| Find all providers in zip 10940 | ||||
| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003054214 | Krassimir Atanassov | Surgery | 707 E Main St, Middletown, NY 10940-2650 | 2009-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619442258 | Northern Westchester Surgical PC | Surgery | 672 Stoneleigh Ave Ste C116, Carmel, NY 10512-4635 | 2018-10-10 |
| 1902248248 | Stanley Wesotski | Surgery | 28 Whitney Gate, Smithtown, NY 11787-1747 | 2013-07-29 |
| 1942596762 | Isadora C Botwinick | Surgery | Hsc Level 19 Room 068, Stony Brook, NY 11794 | 2011-06-20 |
| 1912296195 | Elizabeth Kiselak | Surgery | 5 Summit Ave., Suite 105, Hackensack, NY 07601 | 2011-03-29 |
| 1144546995 | Michael Antonio Vella | Surgery | 601 Elmwood Avenue Box Surg, Rochester, NY 14642-0001 | 2010-04-19 |
| 1952539967 | Amie L Lucia | Surgery | 750 East Adams St Ste. 4835, Syracuse, NY 13210 | 2009-06-29 |
| 1083853428 | Molly Elizabeth Moore | Surgery | 205 Hammocks Dr, Orchard Park, NY 14127-1683 | 2009-02-09 |
| 1356587653 | Andrew Joseph Deroo | Surgery | 43 New Scotlland Dr, Mc-194, Albany, NY 12208 | 2008-12-17 |
| 1831367929 | Fausto Y Vinces Do Pllc | Surgery | 136 Fieldpoint Dr, Irvington, NY 10533-1858 | 2008-02-12 |
| 1104027366 | Sofia Yusuf Naz | Surgery | 199 Underhill St, Yonkers, NY 10710-3810 | 2007-05-29 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLETOWN |
| Zip Code | 10940 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.