Provider Demographics
NPI:1972962504
Name:MCCABE, TARA ANNE (NP)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:ANNE
Last Name:MCCABE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:ANNE
Other - Last Name:PISANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:240 E 38TH ST
Mailing Address - Street 2:19TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2708
Mailing Address - Country:US
Mailing Address - Phone:646-501-4877
Mailing Address - Fax:646-754-7608
Practice Address - Street 1:240 EAST 38TH STREET
Practice Address - Street 2:19TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:646-501-4877
Practice Address - Fax:646-754-7608
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily