Provider Demographics
NPI:1952426215
Name:SUTERA, TANY RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:TANY
Middle Name:RICHARD
Last Name:SUTERA
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 1:222 MAMARONECK AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1304
Mailing Address - Country:US
Mailing Address - Phone:914-761-1121
Mailing Address - Fax:914-761-1132
Practice Address - Street 1:222 MAMARONECK AVE STE 100
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1304
Practice Address - Country:US
Practice Address - Phone:914-761-1121
Practice Address - Fax:914-761-1132
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009823-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor