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General NPI Number Information
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NPI Number | 1598810970
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Entity Type | Organization
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Legal Business Name | TENDERAGE PT INC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 10/15/2010
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Provider Practice Location Address
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Address Line | 1227-2 MONTAUK HWY
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City | OAKDALE
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State | NY
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Zip | 11769-1434
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Country | US
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Telephone | 631-218-1545
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Fax | 631-218-2650
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Provider Business Mailing Address
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Address Line | 1227-2 MONTAUK HWY
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City | OAKDALE
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State | NY
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Zip | 11769-1434
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Country | US
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Telephone | 631-218-1545
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Fax | 631-218-2650
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ELLEN M RASMUSSEN
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Credential | PT
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Telephone | 631-218-1545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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