Individual provider · Type 1 NPI

Tara McDermott-Banta

Specialist · Massapequa, NY

NPI number 1124381025 Active

Practice location

107 Hampton Blvd
Massapequa, NY 11758-7364

Call (516) 205-8822 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X515741041 (NY)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1124381025

Tara McDermott-Banta's National Provider Identifier is 1124381025, issued on Jun 17, 2012. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Massapequa, NY. The record was last updated on Apr 11, 2022.