Provider Demographics
NPI:1790784817
Name:MAKOWSKY, TAMMY BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:BETH
Last Name:MAKOWSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:TAMMY
Other - Middle Name:BETH
Other - Last Name:MACLELLAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:55 RUSTIC WAY
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-9008
Mailing Address - Country:US
Mailing Address - Phone:732-863-0807
Mailing Address - Fax:732-462-7511
Practice Address - Street 1:9 PROFESSIONAL CIR
Practice Address - Street 2:SUITE 107
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2426
Practice Address - Country:US
Practice Address - Phone:732-462-7511
Practice Address - Fax:732-462-2822
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05818500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics