Healthcare Provider Details

I. General information

NPI: 1477831493
Provider Name (Legal Business Name): TARA ARHAKOS L.P.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 WEST ST
MONMOUTH BEACH NJ
07750-1326
US

IV. Provider business mailing address

PO BOX 302
MONMOUTH BEACH NJ
07750-0302
US

V. Phone/Fax

Practice location:
  • Phone: 732-965-5323
  • Fax:
Mailing address:
  • Phone: 732-986-5323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00425700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: