Provider Demographics
NPI:1952327587
Name:TANCREDI F. D'AMORE, M.D FACS. A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:TANCREDI F. D'AMORE, M.D FACS. A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-927-7660
Mailing Address - Street 1:21 TAMAL VISTA BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1130
Mailing Address - Country:US
Mailing Address - Phone:415-927-7660
Mailing Address - Fax:415-927-7663
Practice Address - Street 1:21 TAMAL VISTA BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1130
Practice Address - Country:US
Practice Address - Phone:415-927-7660
Practice Address - Fax:415-927-7663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ32083ZMedicare PIN