Healthcare Provider Details

I. General information

NPI: 1194100776
Provider Name (Legal Business Name): TAMAR FRENKEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 07/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 I U WILLETS RD
ALBERTSON NY
11507-1516
US

IV. Provider business mailing address

201 I U WILLETS RD
ALBERTSON NY
11507-1516
US

V. Phone/Fax

Practice location:
  • Phone: 917-533-3587
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number650345-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: