Healthcare Provider Details

I. General information

NPI: 1992840466
Provider Name (Legal Business Name): TARA CONTILIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR HMC OHS
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

518 DORI PL
STEWARTSVILLE NJ
08886-3209
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6146
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number25MP00039700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: