Provider Demographics
NPI:1497196364
Name:MCCANN, TARA (DO)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:MCCANN
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:PO BOX 22581 RESURRECTION OB/GYNE RESIDENCY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2581
Mailing Address - Country:US
Mailing Address - Phone:610-482-4795
Mailing Address - Fax:856-528-3117
Practice Address - Street 1:919 CONESTOGA RD STE 104
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1352
Practice Address - Country:US
Practice Address - Phone:610-525-6400
Practice Address - Fax:610-525-1801
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2021-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125064222207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology