Provider Demographics
NPI:1336304898
Name:FOLEY, TARA A (LAC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:A
Last Name:FOLEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 RED SCHOOLHOUSE RD
Mailing Address - Street 2:SUITE #7A
Mailing Address - City:CHESTNUT RIDGE NY
Mailing Address - State:NY
Mailing Address - Zip Code:10977
Mailing Address - Country:US
Mailing Address - Phone:914-523-7133
Mailing Address - Fax:
Practice Address - Street 1:100 RED SCHOOLHOUSE RD
Practice Address - Street 2:STE #7A
Practice Address - City:CHESTNUT RIDGE NY
Practice Address - State:NY
Practice Address - Zip Code:10977
Practice Address - Country:US
Practice Address - Phone:914-523-7133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0024801171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist