Provider Demographics
NPI:1932412285
Name:HAMZAVI, TAMMY LEE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LEE
Last Name:HAMZAVI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E 77TH ST
Mailing Address - Street 2:BLACK HALL, 8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1851
Mailing Address - Country:US
Mailing Address - Phone:212-861-2300
Mailing Address - Fax:212-861-2442
Practice Address - Street 1:130 E 77TH ST
Practice Address - Street 2:BLACK HALL, 8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1851
Practice Address - Country:US
Practice Address - Phone:212-861-2300
Practice Address - Fax:212-861-2442
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014069363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant