Tara Broccolo is a Specialist based in Webster, NY. Tara Broccolo practices in Irondequoit, NY. The NPI Number for Tara Broccolo is 1821495581 and holds a License No. 649366951 (New York).
The current practice location address for Tara Broccolo is 2111 Hudson Ave, Irondequoit, NY and can be reached out via phone at 585-520-1783.
Location: 2111 Hudson Ave, Irondequoit, NY, 14580-8571
Provider Profile Details
NPI Number
1821495581
Provider Name
Tara Broccolo
Credential
Provider Entity Type
Individual
Gender
Female
Address
2111 Hudson Ave, Irondequoit, NY, 14580-8571
Phone Number
585-520-1783
Fax Number
Provider Enumeration Date
11/24/2014
Last Update Date
03/09/2024
Provider Business Practice Location Address Details
Address
2111 Hudson Ave
City
State
Zip
14617-4346
Phone Number
585-520-1783
Fax Number
Provider Business Mailing Address Details
Address
2111 Hudson Ave
City
State
Zip
14617-4346
Phone Number
585-520-1783
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
649366951 (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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