Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tiby Iduculla

Individual provider Psychiatric/Mental Health Registered Nurse · NPI 1245901206

Tiby Iduculla is a Psychiatric/Mental Health Registered Nurse in Staten Island, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2021

Practice location Address checks out

777 Seaview Ave
Staten Island, NY 10305-3409
Phone: (718) 667-2600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Registered Nurse (primary) Taxonomy 163WP0808X · Licence 75627601 (NY)

Record details

NPI number1245901206
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 21, 2021
Last updated in NPPESSeptember 21, 2021
Certification dateSeptember 21, 2021

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