MEDICARE: TAMMY FORENZA

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	163W00000X	Registered Nurse	521304	NY

General Provider Information

NPI Number	:	1245538339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY FORENZA

Provider Business Mailing Address
First Line	:	27 WOODRUM DR
Second Line	:
City	:	STONY POINT
State	:	NY
Zip	:	10980-3101
Country	:	US
Telephone Number	:	845-786-2991
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 WOODRUM DR
Second Line	:
City	:	STONY POINT
State	:	NY
Zip	:	10980-3101
Country	:	US
Telephone Number	:	845-786-2991
Fax Number	:

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

Provider Enumeration Date	:	03/14/2011
Last Update Date	:	03/14/2011

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Directions to “ TAMMY FORENZA ” Practice Location

Language	Start Address	Practice Location

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