National Provider Identifier

Tammy Sue Walrath, PA

Tammy Sue Walrath, PA is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Ithaca, NY and a listed phone number of (607) 844-7271.

NPI 1891261228Ithaca, NYMedical Physician Assistant

Profile Overview

NPI
1891261228
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
October 24, 2018
Last Updated
January 13, 2021

Practice Location

  • 201 Dates Dr
  • Ithaca, NY 14850-1345

Phone: (607) 844-7271

Specialties

  • Medical Physician Assistant (363AM0700X)
  • Physician Assistant (363A00000X)
Full Record
NPI
1891261228
Entity Type
Individual
Last Name
Walrath
First Name
Tammy
Middle Name
Sue
Credential
PA
Mailing Street Address
201 Dates Dr
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-1345
Mailing Country
US
Mailing Phone
(607) 844-7271
Practice Street Address
201 Dates Dr
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-1345
Practice Country
US
Practice Phone
(607) 844-7271
Enumeration Date
October 24, 2018
Last Updated
January 13, 2021
Sex
Female
Sole Proprietor
No
Certification Date
January 13, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Medical Physician Assistant (363AM0700X), Physician Assistant (363A00000X)