| Tida Healthcare Llc | |
|
2209 Montauk Dr Crofton MD 21114-3245 | |
| (240) 305-7446 | |
| Not Available |
| Full Name | Tida Healthcare Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2209 Montauk Dr, Crofton, Maryland |
| Authorized Official Name and Position | Ida Mabelle Konchou (PMHNP) |
| Authorized Official Contact | 2403057446 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tida Healthcare Llc 2209 Montauk Dr Crofton MD 21114-3245 Ph: (240) 305-7446 | Tida Healthcare Llc 2209 Montauk Dr Crofton MD 21114-3245 Ph: (240) 305-7446 |
| NPI Number | 1629768775 |
|---|---|
| Provider Enumeration Date | 05/11/2023 |
| Last Update Date | 05/11/2023 |
| Certification Date | 05/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629768775 | NPI | - | NPPES |
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