Provider Demographics
NPI:1801060785
Name:TARA THERAPY, LLC
Entity type:Organization
Organization Name:TARA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:EYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-972-2392
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-0428
Mailing Address - Country:US
Mailing Address - Phone:716-662-4955
Mailing Address - Fax:716-972-0338
Practice Address - Street 1:3690 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1720
Practice Address - Country:US
Practice Address - Phone:716-662-4955
Practice Address - Fax:716-972-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty