Provider Demographics
NPI:1609327790
Name:MCCARTON, TARA
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:MCCARTON
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 1:38 VASSAR ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5119
Mailing Address - Country:US
Mailing Address - Phone:917-922-1404
Mailing Address - Fax:516-488-2058
Practice Address - Street 1:38 VASSAR ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5119
Practice Address - Country:US
Practice Address - Phone:917-922-1404
Practice Address - Fax:516-488-2058
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency