Provider Demographics
NPI:1508208737
Name:TIRADO, ALBANI ROCIO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALBANI
Middle Name:ROCIO
Last Name:TIRADO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 849
Mailing Address - Street 2:47 N. COUNTRY RD.,
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786
Mailing Address - Country:US
Mailing Address - Phone:631-744-0111
Mailing Address - Fax:631-744-0321
Practice Address - Street 1:47 N. COUNTRY RD.
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786
Practice Address - Country:US
Practice Address - Phone:631-744-0111
Practice Address - Fax:631-744-0321
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044665-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist