Provider Demographics
NPI:1669517918
Name:LAPP, TAMI DAWN (OD)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:DAWN
Last Name:LAPP
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1113
Mailing Address - Country:US
Mailing Address - Phone:516-622-6000
Mailing Address - Fax:
Practice Address - Street 1:937 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2564
Practice Address - Country:US
Practice Address - Phone:631-369-0777
Practice Address - Fax:631-369-0976
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005768152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U79718Medicare UPIN
C63742Medicare ID - Type Unspecified
NY79774MMedicare PIN