Ida Tam, ED.D, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

069984 Issued in NY

Practice address

715 Ocean Ter
Staten Island, NY 10301-4542

Phone

(917) 453-4061

NPI assigned

Jul 1, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1225873284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 RUMSON RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145951",
            "telephone_number": "917-453-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 OCEAN TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014542",
            "telephone_number": "917-453-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "IDA",
        "name_prefix": "Dr.",
        "credential": "ED.D, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "069984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahdey Tallat, DO
• Fanny Talledo Bracamonte, LMSW
• Chantal Talmor, MD
• Anthony P Talorico, M.D.
• Jotica Talwar, MD
• Margaret Chifong Tam, NURSE PRACTITIONER
• Ryan Tam
• Wai-Kwok Tam, MD
• Tamara Anna Marie Saukin MD PC
• Tamara Sibalic-Mandic Physician Internal Medicine PC

• Social Worker in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.