| Tucker Group Practice | |
|
2078 Pine St North Baldwin NY 11510-2619 | |
| (917) 459-2431 | |
| Not Available |
| Full Name | Tucker Group Practice |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2078 Pine St, North Baldwin, New York |
| Authorized Official Name and Position | Dyna Tucker (OWNER) |
| Authorized Official Contact | 9174592431 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tucker Group Practice 2078 Pine St North Baldwin NY 11510-2619 Ph: (917) 459-2431 | Tucker Group Practice 2078 Pine St North Baldwin NY 11510-2619 Ph: (917) 459-2431 |
| NPI Number | 1417549361 |
|---|---|
| Provider Enumeration Date | 02/10/2021 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417549361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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