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NPI Code Detail

MEDICARE: DR. ELEONORA TAMAYEVA OD

MEDICARE:  DR. ELEONORA  TAMAYEVA  OD
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
1152W00000XOptometrist007880NY
2152W00000XOptometristTUV007880NY

General Provider Information

NPI Number : 1063768109
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELEONORA TAMAYEVA OD
Provider Business Mailing Address
First Line : 146 MIDDLE NECK RD
Second Line :
City : GREAT NECK
State : NY
Zip : 11021-1246
Country : US
Telephone Number : 516-466-3874
Fax Number :
Provider Business Practice Location Address
First Line : 146 MIDDLE NECK RD
Second Line :
City : GREAT NECK
State : NY
Zip : 11021-1246
Country : US
Telephone Number : 516-466-3874
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2012
Last Update Date : 03/07/2022

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Directions to “ DR. ELEONORA TAMAYEVA OD” Practice Location

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