Provider Demographics
NPI:1083385314
Name:SCHEPIS, TARA ANNE (PA)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:ANNE
Last Name:SCHEPIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:126 CARMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1303
Mailing Address - Country:US
Mailing Address - Phone:516-669-7589
Mailing Address - Fax:
Practice Address - Street 1:126 CARMAN AVE
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1303
Practice Address - Country:US
Practice Address - Phone:516-669-7589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant