Provider Demographics
NPI:1932315322
Name:TAMBURINO, PHILIP F (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:F
Last Name:TAMBURINO
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 TULIP AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-1959
Mailing Address - Country:US
Mailing Address - Phone:516-488-7340
Mailing Address - Fax:
Practice Address - Street 1:99 TULIP AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1959
Practice Address - Country:US
Practice Address - Phone:516-488-7340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032473-1101YA0400X, 101YM0800X, 1041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist