Provider Demographics
NPI:1588920953
Name:STEWART, TAMMY (LPN)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:COOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:79 NEW SCOTLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12047
Mailing Address - Country:US
Mailing Address - Phone:518-549-2500
Mailing Address - Fax:518-549-6534
Practice Address - Street 1:159 WOLF RD
Practice Address - Street 2:SUITE 100A
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-6007
Practice Address - Country:US
Practice Address - Phone:518-437-0152
Practice Address - Fax:518-437-0269
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303040-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse