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NPI Code Detail

MEDICARE: THADDEUS WANDEL M. D., P. C.

MEDICARE: THADDEUS WANDEL M. D., P. C.
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
1207W00000XOphthalmology Physician098683NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447421458
Entity Type Code : Organization
Provider Name (Legal Business Name) : THADDEUS WANDEL M. D., P. C.
Provider Business Mailing Address
First Line : 136 OLD POST RD N
Second Line :
City : CROTON ON HUDSON
State : NY
Zip : 10520-1934
Country : US
Telephone Number : 914-271-5026
Fax Number : 914-271-6592
Provider Business Practice Location Address
First Line : 136 OLD POST RD N
Second Line :
City : CROTON ON HUDSON
State : NY
Zip : 10520-1934
Country : US
Telephone Number : 914-271-5026
Fax Number : 914-271-6592
Authorized Official
Title or Position : OFFICE MANAGER
Name : MS. SHIRLEY BOLLIN
Credential :
Telephone Number : 914-271-5026
Provider Enumeration Date : 03/18/2008
Last Update Date : 03/18/2008

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