Individual ProviderEzza TariqStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address3333 Glendale Ave, Toledo, OH 43614-2426(419) 383-5502PECOS EnrollmentBased on the most recent information from CMS, provider Ezza Tariq is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1144961897Provider TypeIndividualFull NameTariq, EzzaTitleDr.CredentialMDGenderFemaleSole ProprietorYesEnumeration Date4/6/2022Last Updated4/6/2022Contact InformationPractice LocationPractice Address3333 Glendale Ave, Toledo, OH 43614-2426Phone(419) 383-5502Fax(419) 383-5515Mailing LocationMailing Address3333 Glendale Ave, Toledo, OH 43614-2426Phone(419) 383-5502Fax(419) 383-5515Provider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer