Provider Demographics
NPI:1336595578
Name:TARA J BELSARE MD PLLC
Entity Type:Organization
Organization Name:TARA J BELSARE MD PLLC
Other - Org Name:CONTEMPLATIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BELSARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD PLLC
Authorized Official - Phone:607-624-1775
Mailing Address - Street 1:145 CRARY AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-3829
Mailing Address - Country:US
Mailing Address - Phone:607-624-1775
Mailing Address - Fax:607-304-2374
Practice Address - Street 1:3220 PEARL ST
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-5758
Practice Address - Country:US
Practice Address - Phone:607-215-1705
Practice Address - Fax:607-304-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223656-32084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH15464Medicaid