Provider Demographics
NPI:1578940748
Name:TAURO, GINA
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:TAURO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:TILLSON
Mailing Address - State:NY
Mailing Address - Zip Code:12486-0252
Mailing Address - Country:US
Mailing Address - Phone:845-706-0627
Mailing Address - Fax:
Practice Address - Street 1:27 ROSE AVE
Practice Address - Street 2:
Practice Address - City:TILLSON
Practice Address - State:NY
Practice Address - Zip Code:12486-0252
Practice Address - Country:US
Practice Address - Phone:845-706-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist