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General NPI Number Information
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NPI Number | 1629566435
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Entity Type | Individual
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Provider Name | MARIA BIANCA THERESE TINGSON
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Gender | Female
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 140 BEACH 114TH ST
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City | FAR ROCKAWAY
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State | NY
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Zip | 11694-2405
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Country | US
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Telephone | 718-945-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 37 WINDMILL LN
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City | NEW CITY
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State | NY
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Zip | 10956-6120
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Country | US
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Telephone | 845-536-4446
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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 | 022440
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License Number State | NY
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