Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Daniella Tavares

Individual provider Physician Assistant · NPI 1962010447

Daniella Tavares is a Physician Assistant in Hackensack, New Jersey. Qualified in 2020, 6 years ago. Practices with North Shore Lij Urgent Care PC, a 395-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
6
Licensed in
NJ, NY
In the registry since
2020
Specialties on file
4
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Practice location Address checks out

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone: (551) 996-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4422 3rd Ave, Bronx, NY 10457-2545 — (201) 206-7789

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 025366 (NY)
Physician Assistant Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence 25MP00618400 (NJ)
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1962010447
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 21, 2020
Last updated in NPPESNovember 25, 2022
Certification dateNovember 25, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice North Shore Lij Urgent Care Pc — 395 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Hackensack