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NPI Code Detail

MEDICARE: LINA MARCELA TAMAYO

MEDICARE:   LINA MARCELA TAMAYO
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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY

General Provider Information

NPI Number : 1942139738
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINA MARCELA TAMAYO
Provider Business Mailing Address
First Line : 997 STAFFORD AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-2109
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 65 COURT ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-4916
Country : US
Telephone Number : 718-948-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/27/2026

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Directions to “ LINA MARCELA TAMAYO ” Practice Location

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