Provider Demographics
NPI:1093393662
Name:DACHOH, TAMAR A (MD)
Entity type:Individual
Prefix:
First Name:TAMAR
Middle Name:A
Last Name:DACHOH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMAR
Other - Middle Name:A
Other - Last Name:LUNZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:24 ROCKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-1208
Mailing Address - Country:US
Mailing Address - Phone:516-241-1086
Mailing Address - Fax:
Practice Address - Street 1:49 FOREST RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-2923
Practice Address - Country:US
Practice Address - Phone:845-782-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330854-01208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics