Basic Information
| Provider Information | |||||||||
| NPI: | 1518370253 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TYAGI | ||||||||
| FirstName: | MONICA | ||||||||
| MiddleName: | SCHAFFER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3621 S STATE ST | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481081633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346475299 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5769 SALTSBURG RD | ||||||||
| Address2: | |||||||||
| City: | VERONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151473257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127938870 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2014 | ||||||||
| LastUpdateDate: | 08/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD461256 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.