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NPI Code Detail

MEDICARE: TINA M CUDA FNP

MEDICARE: TINA M CUDA FNP
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
1363LF0000XFamily Nurse Practitioner336324NY

General Provider Information

NPI Number : 1467773648
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA M CUDA FNP
Provider Business Mailing Address
First Line : 2209 GENESEE STREET
Second Line : BUSINESS OFFICE ROOM 310
City : UTICA
State : NY
Zip : 13501
Country : US
Telephone Number : 315-801-3282
Fax Number : 315-801-8391
Provider Business Practice Location Address
First Line : 8411 SENECA TPKE
Second Line :
City : NEW HARTFORD
State : NY
Zip : 13413-4912
Country : US
Telephone Number : 315-624-8500
Fax Number : 315-624-8515
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2010
Last Update Date : 03/17/2018

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