Healthcare Provider Details

I. General information

NPI: 1649635830
Provider Name (Legal Business Name): TAMARA NAVARRO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2015
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24825 NORTHERN BLVD STE 1J
LITTLE NECK NY
11362-1280
US

IV. Provider business mailing address

24825 NORTHERN BLVD STE 1J
LITTLE NECK NY
11362-1280
US

V. Phone/Fax

Practice location:
  • Phone: 929-266-4731
  • Fax:
Mailing address:
  • Phone: 929-266-4731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number409075
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: