Individual
MONIQUE SHERRI TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NON-EMERGENCY TRANSP
Contact information
Practice address
120 EASTON AVE, BUFFALO, NY 14215-3531
(716) 322-6198
Mailing address
120 EASTON AVE, BUFFALO, NY 14215-3531
(716) 322-6198
Taxonomy
Speciality
Code
Description
License number
State
2279P4000X
Patient Transport Registered Respiratory Therapist
Primary
04990727
NY
Other
Enumeration date
06/12/2018
Last updated
06/12/2018
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