Provider Demographics
NPI:1538748843
Name:TAM, CINDY (OTR/L)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:
Last Name:TAM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 BOOTH ST APT 301
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4008
Mailing Address - Country:US
Mailing Address - Phone:646-575-7637
Mailing Address - Fax:
Practice Address - Street 1:6445 BOOTH ST APT 301
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4008
Practice Address - Country:US
Practice Address - Phone:646-575-7637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025524225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY025524OtherNEW YORK STATE EDUCATION DEPARTMENT