Provider Demographics
NPI:1619147352
Name:KORDAS, TAMMY MARIE (AUD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:MARIE
Last Name:KORDAS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 SOUTH CROUSE
Mailing Address - Street 2:ROOM 200
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13244-0001
Mailing Address - Country:US
Mailing Address - Phone:315-443-4485
Mailing Address - Fax:
Practice Address - Street 1:805 SOUTH CROUSE
Practice Address - Street 2:ROOM 200
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13244-0001
Practice Address - Country:US
Practice Address - Phone:315-443-4485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001811-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55371AMedicare PIN