Individual
MRS. TARA MARIE PICCOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACITIONER
Contact information
Practice address
350 ANGLE STREET, ANGLEWOOD, NJ 07631
(201) 894-3000
Mailing address
478 ABBOTT AVENUE, RIDGEFIELD, NJ 07657
(201) 334-6634
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ01402700
NJ
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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