Basic Information
Provider Information
NPI: 1568826139
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BISWAS
FirstName: TINKU
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3001 HOSPITAL DRIVE, 5TH FLOOR
Address2: PRINCE GEORGE'S HOSPITAL CENTER, DEPARTMENT OF MEDICINE
City: CHEVERLY
State: MD
PostalCode: 20785
CountryCode: US
TelephoneNumber: 3016183776
FaxNumber: 3016182986
Practice Location
Address1: 3001 HOSPITAL DR
Address2: DEPARTMENT OF MEDICINE 5TH FLOOR
City: CHEVERLY
State: MD
PostalCode: 207851189
CountryCode: US
TelephoneNumber: 3016183776
FaxNumber: 3016182986
Other Information
ProviderEnumerationDate: 04/11/2016
LastUpdateDate: 02/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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