MEDICARE: TAMARA PRIYEV COSMETOLOGIST

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	335E00000X	Prosthetic/Orthotic Supplier	AEC-24-03758	NY

General Provider Information

NPI Number	:	1063358455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA PRIYEV COSMETOLOGIST

Provider Business Mailing Address
First Line	:	6565 WETHEROLE ST APT 3V
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-4739
Country	:	US
Telephone Number	:	917-345-8484
Fax Number	:

Provider Business Practice Location Address
First Line	:	6565 WETHEROLE ST APT 3V
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-4739
Country	:	US
Telephone Number	:	917-345-8484
Fax Number	:

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

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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Directions to “ TAMARA PRIYEV COSMETOLOGIST” Practice Location

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