Provider Demographics
NPI:1700371226
Name:GELERNTER, TARA (AUD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:GELERNTER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:GELERNTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:560 WHITE PLAINS RD STE 615
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-6802
Mailing Address - Country:US
Mailing Address - Phone:914-333-5801
Mailing Address - Fax:
Practice Address - Street 1:1200 WATERS PL STE 110
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-0371
Practice Address - Country:US
Practice Address - Phone:718-863-4366
Practice Address - Fax:718-863-9743
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002791231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist