Tamara Vanderwal, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

48377 Issued in CT

Practice address

342 Harbor St
Branford, CT 06405-4540

Phone

(203) 481-4248

NPI assigned

Dec 27, 2007

Last updated

Nov 6, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Town of Branford

  dba Branford Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Branford, CT
  • NPI 1063437895
  NPD (past)

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1942484977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HARBOR ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054540",
            "telephone_number": "203-481-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 HARBOR ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054540",
            "telephone_number": "203-481-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWAL",
        "first_name": "TAMARA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "48377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leakna Ung, DPM
• Tamara Uptgrow
• Ashley Nicole Uttermann, PA
• Maria Jamie Van Gelder, APRN
• Julia Nicole Vanasse
• Susan Mary Vankeuren
• Michael A Vargas, PA
• Evadne Claudia Vascianna, FNP-C
• Tomas E Veiga, CRNFA
• Matthew David Vesely, M.D., PH.D

• Neurology Physician in Branford, CT
• Providers in Branford, CT by specialty
• Neurology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.