Provider Demographics
NPI:1932701067
Name:TAMMARO, DANIEL MICHAEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:MICHAEL
Last Name:TAMMARO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 OCEANVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1448
Mailing Address - Country:US
Mailing Address - Phone:516-782-7331
Mailing Address - Fax:
Practice Address - Street 1:78 OCEANVIEW AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1448
Practice Address - Country:US
Practice Address - Phone:516-782-7331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant