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General NPI Number Information
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NPI Number | 1013047737
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Entity Type | Organization
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Legal Business Name | ANTHONY R TARDIO MD PC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15 FULTON AVE
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-2315
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Country | US
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Telephone | 845-471-5070
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Fax | 845-471-8901
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Provider Business Mailing Address
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Address Line | 15 FULTON AVE
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-2315
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Country | US
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Telephone | 845-471-5070
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Fax | 845-471-8901
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY RALPH TARDIO
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Credential | MD
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Telephone | 845-471-5070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 105019
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License Number State | NY
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