MEDICARE: TAMARA SONETTA MULLER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	407318	NY
2	363LF0000X	Family Nurse Practitioner	341972	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053810929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA SONETTA MULLER NP

Provider Business Mailing Address
First Line	:	713 EVELYN AVE
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1307
Country	:	US
Telephone Number	:	917-691-5853
Fax Number	:	516-968-2054

Provider Business Practice Location Address
First Line	:	713 EVELYN AVE
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1307
Country	:	US
Telephone Number	:	917-691-5853
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	06/03/2026

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