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Individual
TARA ACCAVALLO
Active
Individual
TARA ACCAVALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
454839
NY
363LF0000X
Family Nurse Practitioner
Primary
F353276
NY
363LP2300X
Primary Care Nurse Practitioner
F353276
NY
Other
Enumeration date
12/01/2008
Last updated
07/22/2024
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