Provider Demographics
NPI:1578597548
Name:TARASKI, BERNADETTE J (DC)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:J
Last Name:TARASKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 57TH ST
Mailing Address - Street 2:SUITE 510
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10107-0001
Mailing Address - Country:US
Mailing Address - Phone:212-265-3457
Mailing Address - Fax:212-581-2397
Practice Address - Street 1:250 W 57TH ST
Practice Address - Street 2:SUITE 510
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10107-0001
Practice Address - Country:US
Practice Address - Phone:212-265-3457
Practice Address - Fax:212-581-2397
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX51211Medicare PIN