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General NPI Number Information
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NPI Number | 1861254179
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Entity Type | Individual
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Provider Name | TAMARA ADOLPHE
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Gender | Female
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 242 E 72ND ST # 1W
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City | NEW YORK
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State | NY
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Zip | 10021-4574
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Country | US
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Telephone | 917-781-2070
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Fax |
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Provider Business Mailing Address
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Address Line | 169 MUNDY AVE
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City | EDISON
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State | NJ
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Zip | 08820-3716
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ14995400
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License Number State | NJ
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