MEDICARE: DADO TANDIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	693086	NY

General Provider Information

NPI Number	:	1235535071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DADO TANDIA

Provider Business Mailing Address
First Line	:	1470 RICHMOND TER APT 1B
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10310-1109
Country	:	US
Telephone Number	:	347-934-3061
Fax Number	:

Provider Business Practice Location Address
First Line	:	1470 RICHMOND TER APT 1B
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10310-1109
Country	:	US
Telephone Number	:	347-934-3061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2014
Last Update Date	:	11/06/2014

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Directions to “ DADO TANDIA ” Practice Location

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