Provider Demographics
NPI:1760542880
Name:BARRIE, TARA J (DPT, OCS, CSCS)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:J
Last Name:BARRIE
Suffix:
Gender:F
Credentials:DPT, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 MOTOR PKWY
Mailing Address - Street 2:STE 307
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:280 DOBBS FERRY RD
Practice Address - Street 2:SUITE 209
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1900
Practice Address - Country:US
Practice Address - Phone:914-428-9698
Practice Address - Fax:914-428-6013
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204811225100000X
RIPT03522225100000X
NY026393-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA192946OtherBCBS PHY THERAPY
VAP00395283OtherMEDICARE RAILROAD
VA010382947Medicaid
VA7293844OtherAETNA
VA7293844OtherAETNA
VA010382947Medicaid