Individual
TARA NEWCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 CLARKSON RD, CENTEREACH, NY 11720-2303
(631) 648-8343
Mailing address
11 CLARKSON RD, CENTEREACH, NY 11720-2303
(631) 648-8343
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
645787
NY
Other
Enumeration date
09/22/2012
Last updated
09/22/2012
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