Individual provider · Type 1 NPI

Tabetha Tanae Tyndale, NURSE PRACTITIONER

Gerontology Nurse Practitioner · Staten Island, NY

NPI number 1508013442 Active

Practice location

1477 Hylan Blvd
Staten Island, NY 10305-1906

Mailing address

189 W Buchanan St
Staten Island, NY 10301-1224

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse 164W00000X287510-1 (NY)
Gerontology Nurse Practitioner Primary 363LG0600X310924 (NY)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1508013442

Tabetha Tanae Tyndale, NURSE PRACTITIONER's National Provider Identifier is 1508013442, issued on Aug 21, 2008. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Staten Island, NY. The record was last updated on Feb 20, 2025.