Individual
TARA R LENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
241 NORTH RD, POUGHKEEPSIE, NY 12601-1154
(845) 483-5951
Mailing address
19 BRADHURST AVE STE 3100N, HAWTHORNE, NY 10532-2140
(914) 909-9018
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
015180
NY
363AS0400X
Surgical Physician Assistant
Primary
015180
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04433712
—
NY
Enumeration date
10/26/2011
Last updated
03/25/2022
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