Provider Demographics
NPI:1073683280
Name:MATHIAS, TAMAR (MD)
Entity Type:Individual
Prefix:
First Name:TAMAR
Middle Name:
Last Name:MATHIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMAR
Other - Middle Name:
Other - Last Name:HANFLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:354 NOD HILL RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-1503
Mailing Address - Country:US
Mailing Address - Phone:475-329-2686
Mailing Address - Fax:203-456-3161
Practice Address - Street 1:7 KENOSIA AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7395
Practice Address - Country:US
Practice Address - Phone:475-329-2686
Practice Address - Fax:203-456-3161
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT520602084P0800X, 2084P0804X
NY2287682084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry