Individual
TARA C HALVAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1101 NOTT ST, SCHENECTADY, NY 12308-2425
(518) 243-4000
Mailing address
1462 ERIE BLVD, ATTN: THE MEDICAL GROUP, SCHENECTADY, NY 12305-1026
(518) 243-1020
(518) 243-1021
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
012606
NY
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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