Provider Demographics
NPI:1558600098
Name:SORAGHAN, TARA ANNE (DPM)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:ANNE
Last Name:SORAGHAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NH
Mailing Address - Zip Code:03584-3508
Mailing Address - Country:US
Mailing Address - Phone:603-788-4911
Mailing Address - Fax:603-788-5027
Practice Address - Street 1:8 CLOVER LN
Practice Address - Street 2:
Practice Address - City:WHITEFIELD
Practice Address - State:NH
Practice Address - Zip Code:03598-3343
Practice Address - Country:US
Practice Address - Phone:603-837-9005
Practice Address - Fax:603-788-5072
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0350213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery