Provider Demographics
NPI:1740435999
Name:TRAMONTANA, TIMOTHY FRANK (MD)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:FRANK
Last Name:TRAMONTANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:635 BARNHILL DR # MS 350C
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5126
Mailing Address - Country:US
Mailing Address - Phone:317-278-0172
Mailing Address - Fax:
Practice Address - Street 1:8278 WILLETT PARKWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027
Practice Address - Country:US
Practice Address - Phone:315-652-1325
Practice Address - Fax:315-857-2886
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY259256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03302421Medicaid
NY03302421Medicaid
NYJ400085028Medicare PIN