Provider Demographics
NPI:1356931091
Name:DR. GRACE D. TAMMERA
Entity type:Organization
Organization Name:DR. GRACE D. TAMMERA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:D
Authorized Official - Last Name:TAMMERA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-428-0100
Mailing Address - Street 1:1192 WHITE HORSE RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2104
Mailing Address - Country:US
Mailing Address - Phone:856-428-0100
Mailing Address - Fax:856-428-6788
Practice Address - Street 1:1192 WHITE HORSE RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2104
Practice Address - Country:US
Practice Address - Phone:856-428-0100
Practice Address - Fax:856-428-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty