Provider Demographics
NPI:1013129469
Name:GREEN-DACHINGER, TAMARA JEAN (TAMARA)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:JEAN
Last Name:GREEN-DACHINGER
Suffix:
Gender:F
Credentials:TAMARA
Other - Prefix:MS
Other - First Name:TAMARA
Other - Middle Name:J
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TAMARA
Mailing Address - Street 1:54 CROSSWAY
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7204
Mailing Address - Country:US
Mailing Address - Phone:914-722-8301
Mailing Address - Fax:914-517-1337
Practice Address - Street 1:244 5TH AVE
Practice Address - Street 2:#8C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7604
Practice Address - Country:US
Practice Address - Phone:914-420-4047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044722-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN8C371Medicare ID - Type Unspecified