Healthcare Provider Details

I. General information

NPI: 1194635128
Provider Name (Legal Business Name): TAMARA MARIE SCHOMBERG LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 MONTAUK HWY UNIT C7020
COPIAGUE NY
11726-4903
US

IV. Provider business mailing address

903 MONTAUK HWY UNIT C7020
COPIAGUE NY
11726-4903
US

V. Phone/Fax

Practice location:
  • Phone: 631-203-1724
  • Fax:
Mailing address:
  • Phone: 631-203-1724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP145512
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: