Individual
MRS. MILDRED ECHEVARRIA THAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
162 W 19TH ST, DEER PARK, NY 11729-4834
(516) 314-2827
Mailing address
DR. NICHOLAS TUCCI, 800 COMMUNITY DRIVE, MANHASSET, NY 11030
(516) 466-0053
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
012545
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012545
DENTAL HYGIENE LICENSE
NY
Enumeration date
01/03/2019
Last updated
01/03/2019
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