Individual
TARA GROSSKOPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
196 E MAIN ST, HUNTINGTON, NY 11743-2922
(631) 271-8030
(631) 271-8448
Mailing address
196 E MAIN ST, HUNTINGTON, NY 11743-2922
(631) 271-8030
(631) 271-8448
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
010293-1
NY
Other
Enumeration date
09/22/2006
Last updated
05/08/2018
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