Provider Demographics
NPI:1770050767
Name:TIRADO, MARIA ROSA (RN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ROSA
Last Name:TIRADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 YANAC ST
Mailing Address - Street 2:
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-2765
Mailing Address - Country:US
Mailing Address - Phone:570-751-3271
Mailing Address - Fax:
Practice Address - Street 1:250 S 21ST ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3851
Practice Address - Country:US
Practice Address - Phone:610-250-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-28
Last Update Date:2018-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN281150163W00000X
VT026.0136149163W00000X
NJ26NR20439900163W00000X
PARN640561163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse