Provider Demographics
NPI:1962558445
Name:TAMBINI, JAMES PATRICK
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PATRICK
Last Name:TAMBINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17A LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4513
Mailing Address - Country:US
Mailing Address - Phone:845-357-4997
Mailing Address - Fax:
Practice Address - Street 1:80 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-1230
Practice Address - Country:US
Practice Address - Phone:973-543-5656
Practice Address - Fax:973-543-7502
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00044200101YA0400X
NJ37PC00163300101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional