Healthcare Provider Details

I. General information

NPI: 1073438420
Provider Name (Legal Business Name): JAMIYLA TINSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 E 176TH ST
BRONX NY
10460-4617
US

IV. Provider business mailing address

980 WESTCHESTER AVE APT 7G
BRONX NY
10459-4465
US

V. Phone/Fax

Practice location:
  • Phone: 718-583-5150
  • Fax:
Mailing address:
  • Phone: 212-767-9531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number42561
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: