Provider Demographics
NPI:1669735098
Name:PRENDAMANO, TSITSINO (MS/TSSLD)
Entity type:Individual
Prefix:MRS
First Name:TSITSINO
Middle Name:
Last Name:PRENDAMANO
Suffix:
Gender:F
Credentials:MS/TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1858 STUART ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2634
Mailing Address - Country:US
Mailing Address - Phone:718-998-9006
Mailing Address - Fax:
Practice Address - Street 1:1858 STUART ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2634
Practice Address - Country:US
Practice Address - Phone:718-998-9006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2421517174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist