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General NPI Number Information
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NPI Number | 1881347904
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Entity Type | Organization
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Legal Business Name | TELLANID INC
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Dates
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Enumeration Date | 01/29/2022
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Last Update Date | 02/19/2022
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Provider Practice Location Address
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Address Line | 601 W 26TH ST 3RD FLOOR, STE 357, DPT# 24061
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City | NEW YORK
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State | NY
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Zip | 10001-2923
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Country | US
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Telephone | 631-891-7773
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Fax |
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Provider Business Mailing Address
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Address Line | 601 W 26TH ST 3RD FLOOR, STE 357, DPT# 24061
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City | NEW YORK
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State | NY
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Zip | 10001-2923
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Country | US
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Telephone | 631-891-7773
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NIDHIN SAMUEL
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Credential |
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Telephone | 315-203-8245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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