I.a. Tangoren, M.d., P.l.l.c.

NPI 1265594584 - Dermatology - 207N00000X

NPI Details
NPI 1265594584
Enumeration Date 12/14/2006
Last Updated 09/24/2013
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name TRACY E. TRACY
Position PRACTICE ADMINISTRATOR
Phone (315) 424-1430
Fax (315) 424-1779
Practice Location
2949 ERIE BLVD E STE 110
SYRACUSE NY, 13224-1460, US
Phone (315) 424-1430
Fax (315) 424-1779
Business Location
2949 ERIE BLVD E STE 110
SYRACUSE NY, 13224-1460, US
Phone (315) 424-1430
Fax (315) 424-1779
Toxanomy
Taxonomy Code 207N00000X
License State New York
License Number 209386-1
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According to our database, I.a. Tangoren, M.d., P.l.l.c. NPI is 1265594584, taxonomy code is 207N00000X and license number is 209386-1, license state is located at New York. I.a. Tangoren, M.d., P.l.l.c. physically located at 2949 Erie Blvd E Ste 110, Syracuse NY, 13224-1460. NPI Number 1033115704 has the healthcare provider type.

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1265594584 NPI number is provided on an as is basis without warranty of any kind. 1265594584 is maintained by the National Plan & Provider Enumeration System. The contents of I.a. Tangoren, M.d., P.l.l.c. are for informational purposes only.