Provider Demographics
NPI:1134341563
Name:TAINOW, TEMMA (LCSW)
Entity type:Individual
Prefix:MS
First Name:TEMMA
Middle Name:
Last Name:TAINOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GROVE STREET
Mailing Address - Street 2:#10
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014
Mailing Address - Country:US
Mailing Address - Phone:212-675-4612
Mailing Address - Fax:212-675-4612
Practice Address - Street 1:25 GROVE ST
Practice Address - Street 2:#10
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-5318
Practice Address - Country:US
Practice Address - Phone:212-675-4612
Practice Address - Fax:212-675-4612
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0221061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYOXFORD HEALTH PANSOtherP420162
NYOXFORD HEALTH PANSOtherP420162