Provider Demographics
NPI:1366763799
Name:GOLDWASER, TAMAR HAYA (MD)
Entity type:Individual
Prefix:
First Name:TAMAR
Middle Name:HAYA
Last Name:GOLDWASER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 86TH ST
Mailing Address - Street 2:APARTMENT 4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4019
Mailing Address - Country:US
Mailing Address - Phone:732-236-3359
Mailing Address - Fax:
Practice Address - Street 1:1300 MORRIS PARK AVE
Practice Address - Street 2:BELFER 501
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1900
Practice Address - Country:US
Practice Address - Phone:718-430-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257344207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology