Individual
MS. TARA MICHELE LAROCCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
100 E 77TH ST, NEW YORK, NY 10075-1850
(212) 434-2454
Mailing address
38 W 73RD ST, APT 4B, NEW YORK, NY 10023-3115
(347) 439-2071
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
007140
NY
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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