MEDICARE: MISS TANYA DAYER BECCAN LPN

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	164W00000X	Licensed Practical Nurse	290992-1	NY

General Provider Information

NPI Number	:	1407100647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TANYA DAYER BECCAN LPN

Provider Business Mailing Address
First Line	:	322 S 6TH AVE
Second Line	:	PH
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-4114
Country	:	US
Telephone Number	:	914-602-6064
Fax Number	:

Provider Business Practice Location Address
First Line	:	322 S 6TH AVE
Second Line	:	PH
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-4114
Country	:	US
Telephone Number	:	914-602-6064
Fax Number	:

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

Provider Enumeration Date	:	11/08/2012
Last Update Date	:	11/08/2012

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