Healthcare Provider Details

I. General information

NPI: 1073429551
Provider Name (Legal Business Name): TAINA LAROSILIERE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAI LAROSILIERE

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 W 30TH ST
NEW YORK NY
10001-4406
US

IV. Provider business mailing address

531 W 143RD ST APT 6C
NEW YORK NY
10031-6028
US

V. Phone/Fax

Practice location:
  • Phone: 212-725-7850
  • Fax:
Mailing address:
  • Phone: 212-725-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: