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Individual

BETH L TACCA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
760 MILLERSPORT HWY, AMHERST, NY 14226-2410
(716) 446-1435
(716) 446-1569
Mailing address
22 WESTWOOD DR, TONAWANDA, NY 14150-5524
(716) 308-6885

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
543658-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
304642
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00028045601
UNIVERA
NY
01
000529289001
BLUE CROSS
NY
05
02892822
NY
01
9514256
INDEPENDENT HEALTH
NY
Enumeration date
05/31/2007
Last updated
03/10/2008
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