Provider Demographics
NPI:1962157883
Name:ASHOK TYAGI DO PA
Entity type:Organization
Organization Name:ASHOK TYAGI DO PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:TYAGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-892-2928
Mailing Address - Street 1:5800 49TH ST N STE 206
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2100
Mailing Address - Country:US
Mailing Address - Phone:727-892-2928
Mailing Address - Fax:
Practice Address - Street 1:5800 49TH ST N STE 206
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2100
Practice Address - Country:US
Practice Address - Phone:727-892-2928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty