Provider Demographics
NPI:1891017232
Name:GELLING-KAPLAN, TARA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:GELLING-KAPLAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:GELLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:263 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1938
Mailing Address - Country:US
Mailing Address - Phone:516-379-1831
Mailing Address - Fax:
Practice Address - Street 1:263 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:NORTH MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-1938
Practice Address - Country:US
Practice Address - Phone:516-379-1831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018282-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist