Tanchajja, Supoj

Tanchajja, Supoj is an sole proprietor health care provider with primary practice located at 338 Court St , Brooklyn NY 11231-4334. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Tanchajja, Supoj can be contacted via phone (718) 748-4603.

Contact Information

Primary practice address
338 Court St Brooklyn NY 11231-4334
Phone: (718) 748-4603
Fax: (718) 625-3189
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X NY129075 New York
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X NY129075 New York

Profile Details

NPI number 1245225549
LBN Legal business name Tanchajja, Supoj
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 13th, 2005
Last updated Aug 18th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245225549 NPPES
New York MEDICAID 00487449

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