MEDICARE: TAMARIS PRINCI LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1013666098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARIS PRINCI LMSW

Provider Business Mailing Address
First Line	:	118 CANDLEWOOD RD
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06825-3661
Country	:	US
Telephone Number	:	203-366-5029
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 DEKALB AVE APT S10
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-1447
Country	:	US
Telephone Number	:	646-942-7940
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2022
Last Update Date	:	03/18/2022

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