Provider Demographics
NPI:1376746727
Name:TAMNY-YOUNG, TARA REBECCA (PHD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:REBECCA
Last Name:TAMNY-YOUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:644 W PUTNAM AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6088
Mailing Address - Country:US
Mailing Address - Phone:914-715-2531
Mailing Address - Fax:
Practice Address - Street 1:10 N BROADWAY
Practice Address - Street 2:SUITE 1D
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-2219
Practice Address - Country:US
Practice Address - Phone:914-715-2531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016730103G00000X
CT003557103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist