Provider Demographics
NPI:1104188929
Name:ARTHUR, TANESHA C
Entity type:Individual
Prefix:MRS
First Name:TANESHA
Middle Name:C
Last Name:ARTHUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 TODD RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-4038
Mailing Address - Country:US
Mailing Address - Phone:646-404-4517
Mailing Address - Fax:
Practice Address - Street 1:56 TODD RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-4038
Practice Address - Country:US
Practice Address - Phone:646-404-4517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist