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NPI Code Detail

MEDICARE: VIDA TANOH-ANTWI

MEDICARE:   VIDA  TANOH-ANTWI
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
11041S0200XSchool Social WorkerNY

General Provider Information

NPI Number : 1447104377
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIDA TANOH-ANTWI
Provider Business Mailing Address
First Line : 1765 SOUTH AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3604
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1765 SOUTH AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3604
Country : US
Telephone Number : 917-559-9208
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2026
Last Update Date : 02/26/2026

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Directions to “ VIDA TANOH-ANTWI ” Practice Location

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