Healthcare Provider Details

I. General information

NPI: 1932973815
Provider Name (Legal Business Name): TAMARA SHEINFIL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAMARA FASS LMSW

II. Dates (important events)

Enumeration Date: 11/10/2023
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14415 68TH RD
FLUSHING NY
11367-1330
US

IV. Provider business mailing address

85 CRESCENT AVE
PASSAIC NJ
07055-2437
US

V. Phone/Fax

Practice location:
  • Phone: 973-264-0023
  • Fax: 973-264-0022
Mailing address:
  • Phone: 973-264-0023
  • Fax: 973-264-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number107992
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: