Individual
ALLEN TISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
268 MOUNTAIN RD, CORNWALL ON HUDSON, NY 12520-1806
(845) 534-2328
Mailing address
268 MOUNTAIN RD, CORNWALL ON HUDSON, NY 12520-1806
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
105400-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00519668
—
NY
01
—
AT0587201
MEDICARE
NY
Enumeration date
12/31/2007
Last updated
12/31/2007
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