Healthcare Provider Details

I. General information

NPI: 1467979310
Provider Name (Legal Business Name): PHILIP FRANK TAMBURRINO PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 08/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N CENTRAL AVE STE 340A
HARTSDALE NY
10530-1952
US

IV. Provider business mailing address

32201 TOWN GREEN DR
ELMSFORD NY
10523-1697
US

V. Phone/Fax

Practice location:
  • Phone: 914-428-5151
  • Fax:
Mailing address:
  • Phone: 914-622-7942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number008099-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: