Provider Demographics
NPI:1114290541
Name:SINGHATEH, TAMBA B (MSED)
Entity Type:Individual
Prefix:
First Name:TAMBA
Middle Name:B
Last Name:SINGHATEH
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 WASHINGTON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2553
Mailing Address - Country:US
Mailing Address - Phone:646-270-5436
Mailing Address - Fax:
Practice Address - Street 1:2139 WASHINGTON AVE APT 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2553
Practice Address - Country:US
Practice Address - Phone:646-270-5436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY751806103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst