Provider Demographics
NPI:1609476886
Name:TAMBOR, BETH (RN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:TAMBOR
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 1:175 BLEECKER ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1441
Mailing Address - Country:US
Mailing Address - Phone:212-289-7593
Mailing Address - Fax:212-289-7728
Practice Address - Street 1:175 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1441
Practice Address - Country:US
Practice Address - Phone:212-289-7593
Practice Address - Fax:212-289-7728
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY577737-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse