Angela Tardanico, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV006974 Issued in NY

Practice address

151 Knollcroft Rd
Lyons, NJ 07939-5001

Phone

(908) 647-0180

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1124114566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 KNOLLCROFT RD",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "079395001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KNOLLCROFT RD",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "079395001",
            "telephone_number": "908-647-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARDANICO",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Bienvenida Soto-Moise, MD
• Lauren St Hill
• Melissa Rose Stellitano, DMD
• Susan K Strahs, RD,CDE
• Bradley David Sussner, PH.D.
• Bigy Thomas, PMHNP
• Bindhu Kanjiravilayil Thomas, M.D.
• Jan Jy-Yean Tien, PHARMD
• Laurie J. Tomaino, CTRS
• Coral Del Mar Torres Ortiz, MA, BC-DMT

• Optometrist in Lyons, NJ
• Providers in Lyons, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.