Provider Demographics
NPI:1750457651
Name:BOHNE, TAMMY LOUISE (DC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LOUISE
Last Name:BOHNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4360 DOUGLASTON PKWY
Mailing Address - Street 2:#305
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363
Mailing Address - Country:US
Mailing Address - Phone:212-686-2244
Mailing Address - Fax:212-213-5735
Practice Address - Street 1:205 EAST 22ND STREET
Practice Address - Street 2:GROUND FLOOR DOCTORS OFFICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-686-2244
Practice Address - Fax:212-213-5735
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0071961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X78811Medicare UPIN