Provider Demographics
NPI:1407100647
Name:BECCAN, TANYA DAYER (LPN)
Entity Type:Individual
Prefix:MISS
First Name:TANYA
Middle Name:DAYER
Last Name:BECCAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 S 6TH AVE
Mailing Address - Street 2:PH
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-4114
Mailing Address - Country:US
Mailing Address - Phone:914-602-6064
Mailing Address - Fax:
Practice Address - Street 1:322 S 6TH AVE
Practice Address - Street 2:PH
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-4114
Practice Address - Country:US
Practice Address - Phone:914-602-6064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290992-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse