Provider Demographics
NPI:1316213945
Name:KADET-TOCHER, MICHELE KAREN (PNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:KAREN
Last Name:KADET-TOCHER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:MRS
Other - First Name:MICHELE
Other - Middle Name:KAREN
Other - Last Name:TOCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PNP
Mailing Address - Street 1:595 ROUTE 25A STE 10
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2647
Mailing Address - Country:US
Mailing Address - Phone:631-821-4202
Mailing Address - Fax:631-821-7371
Practice Address - Street 1:595 ROUTE 25A STE 10
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2647
Practice Address - Country:US
Practice Address - Phone:631-821-4202
Practice Address - Fax:631-821-7371
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381699-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics