Provider Demographics
NPI:1316037773
Name:GARRETSON, TAMMY (RN)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:
Last Name:GARRETSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 NIAGARA STREET
Mailing Address - Street 2:NIAGARA SKILL CENTER
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201
Mailing Address - Country:US
Mailing Address - Phone:716-856-9835
Mailing Address - Fax:716-856-5614
Practice Address - Street 1:430 NIAGARA STREET
Practice Address - Street 2:NIAGARA SKILL CENTER
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201
Practice Address - Country:US
Practice Address - Phone:716-856-9835
Practice Address - Fax:716-856-5614
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY375492-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY375492-1OtherRN