Organization
MICHAEL TEDFORD MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL GEORGE TEDFORD MD (OWNER)
(845) 561-4466
Entity
Organization
Contact information
Practice address
254 ROUTE 17K, STE 204, NEWBURGH, NY 12550
(845) 561-4466
(845) 561-7190
Mailing address
254 ROUTE 17K STE 204, NEWBURGH, NY 12550-8300
(845) 561-4466
(845) 561-7190
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
203269
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01899169
—
NY
Enumeration date
12/04/2007
Last updated
08/28/2018
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