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Individual
BETH L TACCA
Active
Individual
BETH L TACCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
543658-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
304642
NY
Other
Enumeration date
05/31/2007
Last updated
03/10/2008
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