Provider Demographics
NPI:1346063583
Name:MCCAUSKY, TARJIE JAMES
Entity type:Individual
Prefix:
First Name:TARJIE
Middle Name:JAMES
Last Name:MCCAUSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 CARPENTER AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-3615
Mailing Address - Country:US
Mailing Address - Phone:917-238-5035
Mailing Address - Fax:
Practice Address - Street 1:1300 WATERS PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2714
Practice Address - Country:US
Practice Address - Phone:718-239-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY957842163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse