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General NPI Number Information
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NPI Number | 1184921611
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Entity Type | Individual
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Provider Name | TARA ELIZABETH PEARLMAN M.S.CCC-SLP, TSHH
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Gender | Female
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Dates
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Enumeration Date | 02/18/2011
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 379 MT HOPE RD
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City | MIDDLETOWN
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State | NY
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Zip | 10940-7135
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Country | US
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Telephone | 845-344-2292
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Fax |
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Provider Business Mailing Address
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Address Line | 411 COUNTY ROUTE 50
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City | NEW HAMPTON
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State | NY
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Zip | 10958-3503
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Country | US
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Telephone | 845-468-5734
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 015841-1
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License Number State | NY
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