Provider Demographics
NPI:1316377674
Name:TAMBORSKI, NATALIE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:ANN
Last Name:TAMBORSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ANN
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:645 COMMACK RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-5401
Mailing Address - Country:US
Mailing Address - Phone:631-543-8877
Mailing Address - Fax:631-543-8886
Practice Address - Street 1:645 COMMACK RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-5401
Practice Address - Country:US
Practice Address - Phone:631-543-8877
Practice Address - Fax:631-543-8886
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072754-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical