Individual
MRS. TARA MICHELLE NIEDZIALKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
55 CALVARY DR, NORWICH, NY 13815-1032
(607) 336-6362
Mailing address
43 CLEVELAND AVE, APARTMENT #2, BINGHAMTON, NY 13905-3221
(607) 759-4832
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/04/2011
Last updated
01/03/2012
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