Provider Demographics
NPI:1730897075
Name:OSYATINSKY, TAMARA
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:OSYATINSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 E PENN ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4125
Mailing Address - Country:US
Mailing Address - Phone:516-448-9985
Mailing Address - Fax:
Practice Address - Street 1:19707 TURNBERRY WAY
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2566
Practice Address - Country:US
Practice Address - Phone:516-448-9985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic