Basic Information
| Provider Information | |||||||||
| NPI: | 1871160515 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TANVIR SHAGAR NP IN FAMILY HEALTH PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ADAPT WELLNESS SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 273 RIDGE RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142181222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7169296888 | ||||||||
| FaxNumber: | 7162044057 | ||||||||
| Practice Location | |||||||||
| Address1: | 273 RIDGE RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142181222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7169296888 | ||||||||
| FaxNumber: | 7162044057 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2021 | ||||||||
| LastUpdateDate: | 08/02/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SHAGAR | ||||||||
| AuthorizedOfficialFirstName: | TANVIR | ||||||||
| AuthorizedOfficialMiddleName: | HOQUE | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7169296888 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | FNP | ||||||||
| NPICertificationDate: | 08/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.