Deitrick, Tara

Deitrick, Tara is an individual health care provider with primary practice located at 259 1St St , Mineola NY 11501-3957. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Deitrick, Tara can be contacted via phone (516) 741-0570.

Contact Information

Primary practice address
259 1St St Mineola NY 11501-3957
Phone: (516) 741-0570
Fax: (516) 741-8276
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 9330 New York

Profile Details

NPI number 1497855704
LBN Legal business name Deitrick, Tara
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Nov 29th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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