ETHAN A TARASOV MD NPI 1760488068

NPI Information

NPI: 1760488068
Provider Name: ETHAN A TARASOV, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
2501 KUSER RD
HAMILTON, NJ
ZIP 08691
Phone: (609) 585-8800
Get Directions

Ethan A Tarasov, MD is a diagnostic radiology radiology in Hamilton, NJ. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Ethan A Tarasov, MD NPI is 1760488068. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2501 KUSER RD
HAMILTON, NJ
ZIP 08691-302
Phone: (609) 585-8800
Fax: (609) 585-1825

The NPI 1760488068 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/22/2005 and was last updated on 8/24/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	MD035415-E	PENNSYLVANIA	No
2	2085R0202X	Radiology	Diagnostic Radiology	MA04785400	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	E13229	MEDICARE UPIN
2	7345607	MEDICAID	NEW JERSEY
3	01536103	MEDICAID	PENNSYLVANIA
4	186811	MEDICARE PIN	NEW JERSEY
5	695946	MEDICARE PIN	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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