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General NPI Number Information
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NPI Number | 1578354288
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Entity Type | Organization
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Legal Business Name | TATIS NP IN PSYCHIATRY PC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 907 BELMORE AVE
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City | ISLIP TERRACE
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State | NY
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Zip | 11752-1005
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Country | US
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Telephone | 631-944-8399
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Fax | 631-944-8390
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Provider Business Mailing Address
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Address Line | 907 BELMORE AVE
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City | ISLIP TERRACE
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State | NY
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Zip | 11752-1005
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Country | US
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Telephone | 631-944-8399
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Fax | 631-944-8390
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KEN TATIS
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Credential |
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Telephone | 631-944-8399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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