Individual
MRS. TARA L LAFAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43 SPRING ST, SCHUYLERVILLE, NY 12871-1014
(518) 695-3040
(518) 695-3150
Mailing address
20 TERREL WAY, GANSEVOORT, NY 12831-2435
(518) 695-9438
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
00006019
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5391060001
MEDICARE DME
NY
Enumeration date
12/15/2006
Last updated
07/08/2007
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