Individual
TAMARA TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
3415 BAINBRIDGE AVE, BRONX, NY 10467-2403
(718) 741-2450
Taxonomy
Speciality
Code
Description
License number
State
2080P0216X
Pediatric Rheumatology Physician
Primary
289317
NY
Other
Enumeration date
03/30/2015
Last updated
08/26/2020
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