Provider Demographics
NPI:1720251309
Name:ONOFRIO, TAMARA ANN (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:ANN
Last Name:ONOFRIO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SILK STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:13811
Mailing Address - Country:US
Mailing Address - Phone:607-821-9884
Mailing Address - Fax:607-642-8713
Practice Address - Street 1:12 SILK STREET
Practice Address - Street 2:
Practice Address - City:NEWARK VALLEY
Practice Address - State:NY
Practice Address - Zip Code:13811
Practice Address - Country:US
Practice Address - Phone:607-821-9884
Practice Address - Fax:607-642-8713
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR06102311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P39442Medicare UPIN
CC8047Medicare Oscar/Certification
NYP39442Medicare UPIN