Tidd, Carolyn Rae

Tidd, Carolyn Rae is an individual health care provider with primary practice located at 2249 State Route 86 Ste 2 , Saranac Lake NY 12983-5644. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Tidd, Carolyn Rae can be contacted via phone (518) 354-5353.

Contact Information

Primary practice address
2249 State Route 86 Ste 2 Saranac Lake NY 12983-5644
Phone: (518) 354-5353
Fax: (518) 354-8153
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 013307 New York

Profile Details

NPI number 1538492509
LBN Legal business name Tidd, Carolyn Rae
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2009
Last updated Nov 14th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538492509 NPPES
New York Other 013307 STATE LICENSE

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