Provider Demographics
NPI:1215004692
Name:TINDALL, CLAUDIA JEAN
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:JEAN
Last Name:TINDALL
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 1:755 POMANDER WALK
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1669
Mailing Address - Country:US
Mailing Address - Phone:201-801-0743
Mailing Address - Fax:
Practice Address - Street 1:755 POMANDER WALK
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1669
Practice Address - Country:US
Practice Address - Phone:201-801-0743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF401028-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health