Healthcare Provider Details

I. General information

NPI: 1669787792
Provider Name (Legal Business Name): TARA MARIE JUDE EYMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PEARL ST FL 2
PORT CHESTER NY
10573-4611
US

IV. Provider business mailing address

184 LIBERTY ST
NEW HAVEN CT
06519-1625
US

V. Phone/Fax

Practice location:
  • Phone: 914-265-2762
  • Fax:
Mailing address:
  • Phone: 203-688-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number268219
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: