Individual provider · Type 1 NPI

Tara Cherrelle Gilliam, NP

Adult Health Nurse Practitioner · Patchogue, NY

NPI number 1487487302 Active

Practice location

101 Hospital Rd
Patchogue, NY 11772-4870

Mailing address

158 Mark Tree Rd
Centereach, NY 11720-2238

Other practice locations

  • 158 Mark Tree Rd, Centereach, NY 11720-2238 · (631) 740-7774

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200X311842 (NY)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1487487302

Tara Cherrelle Gilliam, NP's National Provider Identifier is 1487487302, issued on Aug 26, 2024. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Patchogue, NY. The record was last updated on Aug 26, 2024.