Healthcare Provider Details

I. General information

NPI: 1013835008
Provider Name (Legal Business Name): TANYA NERONE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MARYS AVE
KINGSTON NY
12401-5852
US

IV. Provider business mailing address

74 CATSKILL AVE
KINGSTON NY
12401-4738
US

V. Phone/Fax

Practice location:
  • Phone: 845-437-5000
  • Fax:
Mailing address:
  • Phone: 845-532-6722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number35993
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: