Provider Demographics
NPI:1982175873
Name:TANGARIFE, ASTRID J
Entity Type:Individual
Prefix:
First Name:ASTRID
Middle Name:J
Last Name:TANGARIFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASTRID
Other - Middle Name:J
Other - Last Name:ACEVEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:34 BEATTIE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34 BEATTIE AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4002
Practice Address - Country:US
Practice Address - Phone:845-699-9970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000OtherNA