MEDICARE: TAMIRA VAN NOY

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	213E00000X	Podiatrist	N005267	NY

General Provider Information

NPI Number	:	1851548408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMIRA VAN NOY

Provider Business Mailing Address
First Line	:	1027 LIBERTY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-2812
Country	:	US
Telephone Number	:	718-348-5981
Fax Number	:

Provider Business Practice Location Address
First Line	:	1027 LIBERTY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-2812
Country	:	US
Telephone Number	:	718-348-5981
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETER
Name	:	TAMIRA VAN NOY
Credential	:
Telephone Number	:	718-348-5981

Provider Enumeration Date	:	08/26/2008
Last Update Date	:	08/26/2008

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Directions to “TAMIRA VAN NOY ” Practice Location

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