Provider Demographics
NPI:1982668802
Name:ZURAKOWSKI, TAMARA LEE (PHD, GNP-BC)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:LEE
Last Name:ZURAKOWSKI
Suffix:
Gender:F
Credentials:PHD, GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 980218
Mailing Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE/GERIATRICS
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298
Mailing Address - Country:US
Mailing Address - Phone:804-254-3500
Mailing Address - Fax:804-254-1616
Practice Address - Street 1:2116 W LABURNUM AVE
Practice Address - Street 2:VCU CTR FOR ADVANCED HEALTH MGMT
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4359
Practice Address - Country:US
Practice Address - Phone:804-254-3500
Practice Address - Fax:804-254-1616
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171134363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS89714Medicare UPIN
PA33926UP005465HOtherHEALTH PARTNERS OF PA
PA2020113000OtherKEYSTONE HEALTH PLAN EAST
PAS89714Medicare UPIN
PA30010921OtherKEYSTONE MERCY HEALTH PLA
PA1327047OtherHIGHMARK BL SHIELD
PA031474Medicare ID - Type Unspecified
PA2423785OtherAETNA HEALTH PLANS
PA017758910002Medicaid