Provider Demographics
NPI:1174252175
Name:TANKO, FARIDA ABBA (MD)
Entity type:Individual
Prefix:DR
First Name:FARIDA
Middle Name:ABBA
Last Name:TANKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5509 WELLS DR
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1317
Mailing Address - Country:US
Mailing Address - Phone:732-771-7036
Mailing Address - Fax:
Practice Address - Street 1:1 ROBERT WOOD JOHNSON PL # PLACE212
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1928
Practice Address - Country:US
Practice Address - Phone:732-235-8121
Practice Address - Fax:732-235-8124
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program