Provider Demographics
NPI:1477137297
Name:TASKA-TENCH, HEIDI (MS, MS, CGC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:TASKA-TENCH
Suffix:
Gender:F
Credentials:MS, MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRADHURST AVE STE 2850
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2183
Mailing Address - Country:US
Mailing Address - Phone:914-304-5280
Mailing Address - Fax:914-234-1753
Practice Address - Street 1:19 BRADHURST AVE STE 2850
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2183
Practice Address - Country:US
Practice Address - Phone:914-304-5280
Practice Address - Fax:914-234-1753
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16364170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS