Basic Information
| Provider Information | |||||||||
| NPI: | 1508429788 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TANPIENGCO | ||||||||
| FirstName: | ERIBERTO | ||||||||
| MiddleName: | OCANA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | BSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 VETERANS MEMORIAL HWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | HAUPPAUGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117882929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6318633700 | ||||||||
| FaxNumber: | 6318633705 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 VETERANS MEMORIAL HWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | HAUPPAUGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117882929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6318633700 | ||||||||
| FaxNumber: | 6318633705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2019 | ||||||||
| LastUpdateDate: | 04/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 614773 | NY | Y | Nursing Service Providers | Registered Nurse |
No ID Information.