Provider Demographics
NPI:1508429788
Name:TANPIENGCO, ERIBERTO OCANA JR (BSN)
Entity Type:Individual
Prefix:
First Name:ERIBERTO
Middle Name:OCANA
Last Name:TANPIENGCO
Suffix:JR
Gender:M
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 VETERANS MEMORIAL HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2929
Mailing Address - Country:US
Mailing Address - Phone:631-863-3700
Mailing Address - Fax:631-863-3705
Practice Address - Street 1:700 VETERANS MEMORIAL HWY STE 200
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2929
Practice Address - Country:US
Practice Address - Phone:631-863-3700
Practice Address - Fax:631-863-3705
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY614773163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse