| Tatyana Fast Md Pc | |
|
160 White Rd Ste 102 Little Silver NJ 07739-1167 | |
| (732) 450-0062 | |
| (732) 450-0616 |
| Full Name | Tatyana Fast Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 160 White Rd Ste 102, Little Silver, New Jersey |
| Authorized Official Name and Position | Tatyana Fast (PRESIDENT) |
| Authorized Official Contact | 7324500062 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tatyana Fast Md Pc 160 White Rd Ste 102 Little Silver NJ 07739-1167 Ph: (732) 450-0062 | Tatyana Fast Md Pc 160 White Rd Ste 102 Little Silver NJ 07739-1167 Ph: (732) 450-0062 |
| NPI Number | 1437898905 |
|---|---|
| Provider Enumeration Date | 06/02/2022 |
| Last Update Date | 06/02/2022 |
| Medicare PECOS PAC ID | 6002299914 |
|---|---|
| Medicare Enrollment ID | O20220810000522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437898905 | NPI | - | NPPES |
| 0052825 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Tatyana Ponti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811099005 PECOS PAC ID: 2567420672 Enrollment ID: I20041221000513 |
| Provider Name | Megan Squires |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1720799869 PECOS PAC ID: 6002280898 Enrollment ID: I20230317000785 |
| Provider Name | Donna Castellano |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295417418 PECOS PAC ID: 3375997406 Enrollment ID: I20230923000126 |
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