Provider Demographics
NPI:1386932176
Name:TANCREDI, MARIA (LAC / LMT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TANCREDI
Suffix:
Gender:F
Credentials:LAC / LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 JACKSON PL
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-7810
Mailing Address - Country:US
Mailing Address - Phone:516-902-1012
Mailing Address - Fax:
Practice Address - Street 1:200 OLD SUNRISE HWY APT SUITE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5545
Practice Address - Country:US
Practice Address - Phone:151-690-2101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005755-01171100000X
NY016931-1172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Yes171100000XOther Service ProvidersAcupuncturist