Provider Demographics
NPI:1770680126
Name:TILDEN, CRAIG M (DC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:M
Last Name:TILDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5105
Mailing Address - Country:US
Mailing Address - Phone:914-423-9825
Mailing Address - Fax:
Practice Address - Street 1:NORTH EAST PHYSICAL MEDICINE & REHABILITATION
Practice Address - Street 2:1620 TOWNE CENTER - ROUTE 22
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509
Practice Address - Country:US
Practice Address - Phone:845-279-1135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXO11111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor