=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609741388
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAM NY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2025
-----------------------------------------------------
Last Update Date | 10/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 641 E TREMONT AVE
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10457-4932
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-618-7305
-----------------------------------------------------
Fax | 718-618-7306
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 641 E TREMONT AVE
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10457-4932
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-618-7305
-----------------------------------------------------
Fax | 718-618-7306
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | STEPHEN STEPHEN MENSAH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 718-618-7305
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------