Provider Demographics
NPI:1215215819
Name:WOOD, TAMMY LYNN (MS PA-C)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:LYNN
Last Name:WOOD
Suffix:
Gender:F
Credentials:MS PA-C
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Mailing Address - Street 1:1945 STATE ROUTE 33
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4859
Mailing Address - Country:US
Mailing Address - Phone:732-413-3626
Mailing Address - Fax:732-776-2344
Practice Address - Street 1:2100 CORLIES AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-6102
Practice Address - Country:US
Practice Address - Phone:732-263-7960
Practice Address - Fax:732-263-7961
Is Sole Proprietor?:No
Enumeration Date:2011-07-30
Last Update Date:2020-01-08
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00317700363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical