Provider Demographics
NPI:1952067290
Name:TRICOCHE, TANISE
Entity type:Individual
Prefix:
First Name:TANISE
Middle Name:
Last Name:TRICOCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E GIBBSBORO RD APT 1311
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-1920
Mailing Address - Country:US
Mailing Address - Phone:856-593-4019
Mailing Address - Fax:
Practice Address - Street 1:101 E GIBBSBORO RD APT 1311
Practice Address - Street 2:
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-1920
Practice Address - Country:US
Practice Address - Phone:856-593-4019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No156F00000XEye and Vision Services ProvidersTechnician/Technologist