Individual provider · Type 1 NPI
Tara Accavallo, FNP-BC
Family Nurse Practitioner · Commack, NY
NPI number
1013162346
Active
Practice location
5036 Jericho Tpke Ste 207
Commack, NY 11725-2812
Fax (631) 486-8374
Mailing address
14 Clark St
Selden, NY 11784-2257
Other practice locations
- 14 Clark St, Selden, NY 11784-2257 · (631) 846-6594
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 454839 (NY) |
| Primary Care Nurse Practitioner | 363LP2300X | F353276 (NY) |
| Family Nurse Practitioner Primary | 363LF0000X | F353276 (NY) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1013162346
Tara Accavallo, FNP-BC's National Provider Identifier is 1013162346, issued on Dec 1, 2008. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Commack, NY. The record was last updated on Jul 22, 2024.