Basic Information
Provider Information
NPI: 1770501041
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAY
FirstName: TANIKA
MiddleName: LASIEN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4225 ALTAMONT PL STE 201
Address2:  
City: WHITE PLAINS
State: MD
PostalCode: 206953065
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4225 ALTAMONT PL STE 201
Address2:  
City: WHITE PLAINS
State: MD
PostalCode: 206953065
CountryCode: US
TelephoneNumber: 2406071500
FaxNumber: 2406071510
Other Information
ProviderEnumerationDate: 07/17/2006
LastUpdateDate: 05/09/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XD0064929MDY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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