Provider Demographics
NPI:1295084556
Name:BROWN, TAMARA A
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 2ND AVE
Mailing Address - Street 2:APT 8D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-2240
Mailing Address - Country:US
Mailing Address - Phone:914-396-4316
Mailing Address - Fax:
Practice Address - Street 1:2185 2ND AVE
Practice Address - Street 2:APT 8D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2240
Practice Address - Country:US
Practice Address - Phone:914-396-4316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2012-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007259224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant