Provider Demographics
NPI:1073989505
Name:CARINCI, TARAH
Entity Type:Individual
Prefix:
First Name:TARAH
Middle Name:
Last Name:CARINCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TARAH
Other - Middle Name:
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:520 SCONONDOA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-1719
Mailing Address - Country:US
Mailing Address - Phone:678-761-0214
Mailing Address - Fax:
Practice Address - Street 1:520 SCONONDOA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-1719
Practice Address - Country:US
Practice Address - Phone:678-761-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306059-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse