Healthcare Provider Details

I. General information

NPI: 1407809916
Provider Name (Legal Business Name): TEJINDER S. VIRDEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/28/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 SENECA ST SUITE 2
HORNELL NY
14843-1336
US

IV. Provider business mailing address

181 SENECA ST STE 2
HORNELL NY
14843-1335
US

V. Phone/Fax

Practice location:
  • Phone: 607-324-0660
  • Fax: 607-324-0770
Mailing address:
  • Phone: 607-324-1372
  • Fax: 607-324-1374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number194530
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number194530
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: