Healthcare Provider Details
I. General information
NPI: 1528462025
Provider Name (Legal Business Name): TINA NIGHMAN-POWER
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/14/2014
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
75 SEMINARY HILL RD
CARMEL NY
10512-1921
US
IV. Provider business mailing address
PO BOX 417147
BOSTON MA
02241-7147
US
V. Phone/Fax
- Phone: 800-989-2676
- Fax: 845-704-6178
- Phone: 845-225-5202
- Fax: 845-704-6178
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: