Provider Demographics
NPI:1659643278
Name:ADAMS, TRACY MICHELLE (DO)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:MICHELLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:120 MINEOLA BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4064
Mailing Address - Country:US
Mailing Address - Phone:516-666-3020
Mailing Address - Fax:516-663-3026
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4064
Practice Address - Country:US
Practice Address - Phone:516-666-3020
Practice Address - Fax:516-663-3026
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2021-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY265338-1207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine