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NPI 1699702886

NPI 1699702886 : CONCEPTION TIRADO RD : MONTROSE, NY

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General NPI Number Information
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    NPI Number           |    1699702886
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    Entity Type          |    Individual 
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    Provider Name        |    CONCEPTION TIRADO RD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/26/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2094 ALBANY POST RD 
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    City                 |    MONTROSE
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    State                |    NY
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    Zip                  |    10548-1454
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    Country              |    US
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    Telephone            |    914-737-4400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    46 ALPINE RD 
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    City                 |    YONKERS
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    State                |    NY
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    Zip                  |    10710-2002
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    Country              |    US
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    Telephone            |    914-961-5135
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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        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    
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    License Number State |    
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