Organization Name: | TENDER CARE HEALTH SOLUTIONS |
NPI Number: | 1710359179 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEISHA BURRELL (NP) |
Mailing Address: | 2568 Western Ave Building 4, Apt 6 Altamont |
State: | NY US |
Postal Code: | 120099411 |
Phone Number: | 3474096288 |
Fax Number: | |
NPI Enumeration Date: | 10/26/2015 |
NPI Last Update Date: | 10/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 33-3372244 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |