Provider Demographics
NPI:1760661417
Name:TANGREDI, MARY NEUBAUER (NP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:NEUBAUER
Last Name:TANGREDI
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:270 PARK AVE
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-351-2300
Mailing Address - Fax:631-351-2536
Practice Address - Street 1:270 PARK AVE
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-351-2300
Practice Address - Fax:631-351-2536
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF3019271363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner