Basic Information
| Provider Information | |||||||||
| NPI: | 1609198779 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TIWARI | ||||||||
| FirstName: | AMBOOJ | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43 WESTMINSTER AVE | ||||||||
| Address2: | |||||||||
| City: | BERGENFIELD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076213913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2013871957 | ||||||||
| FaxNumber: | 2013871036 | ||||||||
| Practice Location | |||||||||
| Address1: | 15031 RINALDI ST | ||||||||
| Address2: | |||||||||
| City: | MISSION HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913451207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8183658051 | ||||||||
| FaxNumber: | 8188974701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2010 | ||||||||
| LastUpdateDate: | 08/13/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084V0102X | 25MA09637400 | NJ | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 2085R0204X | 276012-1 | NY | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2085R0204X | 25MA09637400 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2084V0102X | 276012-1 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology |
No ID Information.