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Tara Mcdermott-banta
Specialist in Massapequa, New York
NPI 1124381025

Tara Mcdermott-banta is a Specialist based in Massapequa, NY. Tara Mcdermott-banta practices in Massapequa, NY. The NPI Number for Tara Mcdermott-banta is 1124381025 and holds a License No. 515741041 (New York).

The current practice location address for Tara Mcdermott-banta is 107 Hampton Blvd, Massapequa, NY and can be reached out via phone at 516-205-8822.

Location: 107 Hampton Blvd, Massapequa, NY, 11758-7364
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124381025
Provider Name
Tara Mcdermott-banta
Credential
Provider Entity Type
Individual
Gender
Female
Address
107 Hampton Blvd, Massapequa, NY, 11758-7364
Phone Number
516-205-8822
Fax Number
Provider Enumeration Date
06/17/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
107 Hampton Blvd
City
Massapequa
State
New York
Zip
11758-7364
Phone Number
516-205-8822
Fax Number
person
Provider Business Mailing Address Details
Address
107 Hampton Blvd
City
Massapequa
State
New York
Zip
11758-7364
Phone Number
516-205-8822
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
515741041 (New York)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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