Basic Information
| Provider Information | |||||||||
| NPI: | 1639289457 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAMPONE | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | JOAN | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 HEATHERDELL RD | ||||||||
| Address2: | |||||||||
| City: | ARDSLEY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105021520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146932290 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1000 PELHAM PKWY SOUTH | ||||||||
| Address2: | MORNINGSIDE HOUSE NURSING HOME | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184098243 | ||||||||
| FaxNumber: | 7188280145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 040541 | NY | Y | Dental Providers | Dentist |
No ID Information.