Healthcare Provider Details

I. General information

NPI: 1700371226
Provider Name (Legal Business Name): TARA GELERNTER AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. TARA GELERNTER

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 06/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WATERS PL STE 110
BRONX NY
10461-0371
US

IV. Provider business mailing address

560 WHITE PLAINS RD STE 615
TARRYTOWN NY
10591-6802
US

V. Phone/Fax

Practice location:
  • Phone: 718-863-4366
  • Fax: 718-863-9743
Mailing address:
  • Phone: 914-333-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number002791
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: