Provider Demographics
NPI:1659786440
Name:TAMAYEV, ROBERT (MD-PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:TAMAYEV
Suffix:
Gender:M
Credentials:MD-PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10841 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2336
Mailing Address - Country:US
Mailing Address - Phone:347-336-5972
Mailing Address - Fax:212-686-6329
Practice Address - Street 1:9876 QUEENS BLVD # 1JK
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4398
Practice Address - Country:US
Practice Address - Phone:347-336-5972
Practice Address - Fax:347-851-1942
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292021207RA0201X, 207K00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program