Individual
ANDRE EDWARD TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PEER SPECIALIST
Contact information
Practice address
2037 UTICA AVE, BROOKLYN, NY 11234-3234
(718) 377-7757
(718) 758-9497
Mailing address
2037 UTICA AVE, BROOKLYN, NY 11234-3234
(718) 377-7757
(718) 758-9497
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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