Individual
LAURIE TARE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
20 PROSPECT AVE, SUITE 912, HACKENSACK, NJ 07601-1997
(201) 996-3144
Mailing address
20 PROSPECT AVE, SUITE 912, HACKENSACK, NJ 07601-1997
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00143000
NJ
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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