Individual
BRENDAN MC DADE TEDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
283 BROOKVILLE AVE, ISLIP, NY 11751-1110
(516) 991-0910
Mailing address
283 BROOKVILLE AVE, ISLIP, NY 11751-1110
(516) 991-0910
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2867536
NY
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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