Peter Tah MD PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MA058769 Issued in NJ

Legal business name

PETER TAH MD PA

Practice address

930 Clifton Ave
Suite 104
Clifton, NJ 07013-2723

Phone

(973) 405-6333

NPI assigned

Jan 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter Tah, MDNPI 1548254428

Title

Owner

Phone

(973) 405-6333

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter A Tah, MD

  • Obstetrics & Gynecology Physician
  • Clifton, NJ
  • NPI 1548254428
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053466722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07510",
            "telephone_number": "201-512-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 CLIFTON AVE",
            "address_2": "SUITE 104",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132723",
            "telephone_number": "973-405-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER TAH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-405-6333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "MA058769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6591701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Megan Perry, M.S., CF-SLP
• Colleen M Peruo, C.P.
• Peter Tah MD PA LLC
• Velimir Rumenov Petkov, DPM
• Madelyn Petrucci
• Pooja Philip, LSW
• PHMD & Wellness LLC

• Obstetrics & Gynecology Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.