Provider Demographics
NPI:1639589807
Name:AMOROSA, TARAH LIANA (MD)
Entity Type:Individual
Prefix:MRS
First Name:TARAH
Middle Name:LIANA
Last Name:AMOROSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TARAH
Other - Middle Name:LIANA
Other - Last Name:SCANLON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:462 FIRST AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:315-749-3441
Mailing Address - Fax:
Practice Address - Street 1:462 FIRST AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:315-749-3441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program