Healthcare Provider Details

I. General information

NPI: 1487182184
Provider Name (Legal Business Name): SARESKA TAMAYO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1156 N BROADWAY
YONKERS NY
10701-1108
US

IV. Provider business mailing address

55 ORCHARD ST # F1
ELIZABETH NJ
07208-3603
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number024019
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: