# MR. JOHN TATARAKIS JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1639331721
- **Gender:** Man
- **Credential:** RN, PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | F402357-1 | NY | Yes |
| 364SP0808X | Psychiatric/Mental Health Clinical Nurse Specialist | 414287 | NY | — |

## Other

- **Enumeration date:** 06/30/2008
- **Last updated:** 03/07/2019