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General NPI Number Information
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NPI Number | 1285929042
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Entity Type | Organization
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Legal Business Name | FLORENCE TAM, PSY.D., PLLC
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 201 BRYSON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-1922
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Country | US
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Telephone | 646-481-5386
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Fax | 718-370-2150
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Provider Business Mailing Address
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Address Line | 201 BRYSON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-1922
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Country | US
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Telephone | 646-481-5386
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Fax | 718-370-2150
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. FLORENCE TAM
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Credential | PSY.D.
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Telephone | 646-481-5386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 014047
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License Number State | NY
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