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General NPI Number Information
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NPI Number | 1619858313
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Entity Type | Organization
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Legal Business Name | BRIGHTED BY TAMARA INC
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 9817 HORACE HARDING EXPY APT 5D
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City | CORONA
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State | NY
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Zip | 11368-4228
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Country | US
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Telephone | 347-332-9207
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Fax |
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Provider Business Mailing Address
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Address Line | 9817 HORACE HARDING EXPY APT 5D
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City | CORONA
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State | NY
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Zip | 11368-4228
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Country | US
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Telephone | 347-332-9207
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAMARA SULEYMANOVA
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Credential | MSED
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Telephone | 347-332-9207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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