Provider Demographics
NPI:1235153784
Name:TAMBURRINO, JOSEPH S (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:TAMBURRINO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:EASTPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11941
Mailing Address - Country:US
Mailing Address - Phone:631-666-8100
Mailing Address - Fax:631-665-2227
Practice Address - Street 1:24 BRENTWOOD ROAD
Practice Address - Street 2:
Practice Address - City:BAYSHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-666-8100
Practice Address - Fax:631-665-2227
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002519-1213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4295870001Medicare NSC
NYT50793Medicare UPIN
NY4295870002Medicare NSC
NYP52911Medicare PIN