Provider Demographics
NPI:1174751952
Name:TIRINGER, SETH THOMAS (OTR/L)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:THOMAS
Last Name:TIRINGER
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 W GRANADA AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6442
Mailing Address - Country:US
Mailing Address - Phone:631-742-0162
Mailing Address - Fax:
Practice Address - Street 1:15 W GRANADA AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-6442
Practice Address - Country:US
Practice Address - Phone:631-742-0162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014448-1172V00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No174400000XOther Service ProvidersSpecialist