Individual
DEBORAH TAVERNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-5454
Mailing address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-5454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010774
NY
374T00000X
Religious Nonmedical Nursing Personnel
Primary
010774
NY
Other
Enumeration date
03/31/2007
Last updated
03/31/2026
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