Provider Demographics
NPI:1275780777
Name:AMIRI, TAMELA MINA (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMELA
Middle Name:MINA
Last Name:AMIRI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SYLVAN RD S
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4639
Mailing Address - Country:US
Mailing Address - Phone:203-221-4705
Mailing Address - Fax:203-221-8206
Practice Address - Street 1:3 SYLVAN RD S
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4639
Practice Address - Country:US
Practice Address - Phone:203-221-4705
Practice Address - Fax:203-221-8206
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0291952084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry