MEDICARE: CHRISTINE TIGHE NPP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F400070-1	NY

General Provider Information

NPI Number	:	1578660734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE TIGHE NPP

Provider Business Mailing Address
First Line	:	6800 JERICHO TPKE
Second Line	:	SUITE 122W
City	:	SYOSSET
State	:	NY
Zip	:	11791-4436
Country	:	US
Telephone Number	:	631-754-8892
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 JERICHO TPKE
Second Line	:	SUITE 122W
City	:	SYOSSET
State	:	NY
Zip	:	11791-4436
Country	:	US
Telephone Number	:	631-754-8892
Fax Number	:

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/23/2009

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