Provider Demographics
NPI:1841787827
Name:TAMANNA, NURI S (MD)
Entity type:Individual
Prefix:
First Name:NURI
Middle Name:S
Last Name:TAMANNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E. ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-464-5910
Mailing Address - Fax:315-464-1937
Practice Address - Street 1:750 E. ADAMS ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-5910
Practice Address - Fax:315-464-1937
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311891208M00000X, 207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine