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Individual
MRS. TARA N. LUYSTER
Active
Individual
MRS. TARA N. LUYSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00447500
NJ
363A00000X
Physician Assistant
PA00591
RI
363AS0400X
Surgical Physician Assistant
014723
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021424
MEDICARE PTAN
RI
05
—
TG84594
—
RI
Enumeration date
04/21/2011
Last updated
05/02/2024
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