Individual
DR. SCOTT TASHIRO TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8565 JERICHO TPKE, WOODBURY, NY 11797-1804
(516) 367-3400
Mailing address
155E 38TH ST 6L, NEW YORK, NY 10016-2675
(516) 457-0757
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV007268
NY
Other
Enumeration date
07/08/2008
Last updated
04/08/2016
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