Provider Demographics
NPI:1316606973
Name:TMB MEDICAL CORP
Entity type:Organization
Organization Name:TMB MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:MALKA
Authorized Official - Last Name:BLANCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-669-7866
Mailing Address - Street 1:255 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-2512
Mailing Address - Country:US
Mailing Address - Phone:201-669-7866
Mailing Address - Fax:
Practice Address - Street 1:440 65TH ST
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-2535
Practice Address - Country:US
Practice Address - Phone:201-669-7866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty