Provider Demographics
NPI:1023370145
Name:TARA VIGH, INC.
Entity Type:Organization
Organization Name:TARA VIGH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HARRINGTON-VIGH
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED, BCBA
Authorized Official - Phone:917-664-9268
Mailing Address - Street 1:7801 67TH RD
Mailing Address - Street 2:PH
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2842
Mailing Address - Country:US
Mailing Address - Phone:917-664-9268
Mailing Address - Fax:718-894-0904
Practice Address - Street 1:7801 67TH RD
Practice Address - Street 2:PH
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2842
Practice Address - Country:US
Practice Address - Phone:917-664-9268
Practice Address - Fax:718-894-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty