Individual provider · Type 1 NPI
Tiby Iduculla
Psychiatric/Mental Health Registered Nurse · Staten Island, NY
NPI number
1245901206
Active
Practice location
777 Seaview Ave
Staten Island, NY 10305-3409
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Registered Nurse Primary | 163WP0808X | 75627601 (NY) |
Psychiatric/Mental Health Registered Nurse: Definition to come...
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About NPI 1245901206
Tiby Iduculla's National Provider Identifier is 1245901206, issued on Sep 21, 2021. The primary taxonomy on file is Psychiatric/Mental Health Registered Nurse (163WP0808X), and the practice location is in Staten Island, NY. The record was last updated on Sep 21, 2021.