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General NPI Number Information
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NPI Number | 1447421458
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Entity Type | Organization
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Legal Business Name | THADDEUS WANDEL M. D., P. C.
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 136 OLD POST RD N
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City | CROTON ON HUDSON
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State | NY
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Zip | 10520-1934
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Country | US
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Telephone | 914-271-5026
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Fax | 914-271-6592
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Provider Business Mailing Address
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Address Line | 136 OLD POST RD N
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City | CROTON ON HUDSON
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State | NY
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Zip | 10520-1934
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Country | US
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Telephone | 914-271-5026
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Fax | 914-271-6592
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. SHIRLEY BOLLIN
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Credential |
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Telephone | 914-271-5026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 098683
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License Number State | NY
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