Healthcare Provider Details

I. General information

NPI: 1912662990
Provider Name (Legal Business Name): TARA FRANCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2021
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 W MERRICK RD
VALLEY STREAM NY
11580-5512
US

IV. Provider business mailing address

198 W MERRICK RD
VALLEY STREAM NY
11580-5512
US

V. Phone/Fax

Practice location:
  • Phone: 516-561-1400
  • Fax:
Mailing address:
  • Phone: 516-561-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number068454
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: