Provider Demographics
NPI:1184059446
Name:TAMAROVA, AIDA (TEACHER)
Entity type:Individual
Prefix:MRS
First Name:AIDA
Middle Name:
Last Name:TAMAROVA
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:MRS
Other - First Name:AIDA
Other - Middle Name:
Other - Last Name:TAMAROVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:TEACHER
Mailing Address - Street 1:15218 UNION TPKE APT 10R
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3926
Mailing Address - Country:US
Mailing Address - Phone:917-254-9080
Mailing Address - Fax:
Practice Address - Street 1:15218 UNION TPKE APT 10R
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3926
Practice Address - Country:US
Practice Address - Phone:917-254-9080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1416829174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist