Doctor Name: | MRS. KRISTIN NOELLE TANTILLO |
NPI Number: | 1063641058 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 019795 |
Business Practice Address: | 3117 Military Rd Niagara Falls, NY - 143044813 |
Business Phone Number: | 7169301060 |
Business Fax Number: | 7162984778 |
Mailing Address: | 1221 Brandi Dr, NIAGARA FALLS |
State: | NY |
Postal Code: | 143045802 |
Phone Number: | 7169301060 |
Fax Number: | 7162984779 |
NPI Enumeration Date: | 07/10/2009 |
NPI Last Update Date: | 07/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 019795 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |