Individual
TARA RENEE O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 PROSPECT AVE STE 903, HACKENSACK, NJ 07601-1999
(551) 228-2208
Mailing address
PO BOX 1093, ISLAND HEIGHTS, NJ 08732-1093
(732) 703-5915
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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