IndividualActive
Michael Tavill, MD
NPI 1417030792 · Pediatric Otolaryngology Physician · Shrewsbury, NJ
Provider details
- NPI number
- 1417030792
- Entity type
- Individual
- Primary specialty
- Pediatric Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 25MA06549000 (NJ)
Practice location
1131 Broad Street
Ste 103
Shrewsbury, NJ 07702
Phone: (732) 389-3388
Fax: (732) 389-3389
Mailing address
660 White Plains Rd Fl 4
Tarrytown, NY 10591-5139
Registry dates
- Enumerated
- 2006-10-23
- Last updated
- 2019-04-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.