Provider Demographics
NPI:1851654347
Name:BUCHRIESER, TANYA BRIGITTE (MSED)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:BRIGITTE
Last Name:BUCHRIESER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BIRCHFIELD CT
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-1114
Mailing Address - Country:US
Mailing Address - Phone:516-356-0451
Mailing Address - Fax:
Practice Address - Street 1:22 BIRCHFIELD CT
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-1114
Practice Address - Country:US
Practice Address - Phone:516-356-0451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7181174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist