Provider Demographics
NPI:1811049414
Name:ARMSTRONG, TARA (PA-C)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:SKALETSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:541 MAIN ST
Mailing Address - Street 2:SUITE 414
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1868
Mailing Address - Country:US
Mailing Address - Phone:781-952-1433
Mailing Address - Fax:508-630-2462
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 414
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-952-1433
Practice Address - Fax:508-630-2462
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3769363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical