MEDICARE: DR. JOHN TIGHE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	213603	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	060054491	OTHER	NY	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	54B113K222	OTHER	NY	PTAN

General Provider Information

NPI Number	:	1336142108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN TIGHE MD

Provider Business Mailing Address
First Line	:	PO BOX 5046
Second Line	:	CLIENT ID # 400004
City	:	NEW BRITAIN
State	:	CT
Zip	:	06050-5046
Country	:	US
Telephone Number	:	212-563-2497
Fax Number	:	914-493-5827

Provider Business Practice Location Address
First Line	:	575 HUDSON VALLEY AVE
Second Line	:	STE 200
City	:	NEW WINDSOR
State	:	NY
Zip	:	12553-4746
Country	:	US
Telephone Number	:	845-561-2773
Fax Number	:	914-593-7881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	04/30/2021

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Directions to “ DR. JOHN TIGHE MD” Practice Location

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