Healthcare Provider Details

I. General information

NPI: 1639085624
Provider Name (Legal Business Name): TAMD MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CHAZ WAY
FAIRFIELD NJ
07004-3610
US

IV. Provider business mailing address

7 CHAZ WAY
FAIRFIELD NJ
07004-3610
US

V. Phone/Fax

Practice location:
  • Phone: 914-967-5879
  • Fax:
Mailing address:
  • Phone: 914-967-5879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: EBBENY JEWEL LEWIS
Title or Position: OWNER
Credential:
Phone: 914-967-5879