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General NPI Number Information
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NPI Number | 1235327743
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Entity Type | Individual
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Provider Name | DR. TARA ROONEY
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Gender | Female
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 15211 UNION TPKE CENTER FOR PSYCHOLOGICAL SERVICES
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City | FLUSHING
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State | NY
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Zip | 11367-3908
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Country | US
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Telephone | 516-502-2037
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Fax |
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Provider Business Mailing Address
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Address Line | 15211 UNION TPKE CENTER FOR PSYCHOLOGICAL SERVICES
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City | FLUSHING
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State | NY
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Zip | 11367-3908
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Country | US
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Telephone | 516-502-2037
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 017368
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License Number State | NY
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