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General NPI Number Information
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NPI Number | 1558376269
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Entity Type | Individual
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Provider Name | MADELEINE M TARDIF
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Gender | Female
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7 COMMUNITY DR
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City | BUFFALO
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State | NY
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Zip | 14225-2523
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Country | US
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Telephone | 716-505-5630
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Fax | 716-892-1936
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Provider Business Mailing Address
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Address Line | 695 CRESCENT AVE
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City | BUFFALO
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State | NY
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Zip | 14216-3413
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Country | US
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Telephone | 716-834-6514
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 006243
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License Number State | NY
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