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General NPI Number Information
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NPI Number | 1275922460
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Entity Type | Individual
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Provider Name | TARA BROT
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Gender | Female
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Dates
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Enumeration Date | 01/12/2015
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 147 W 79TH ST APARTMENT 8 C
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City | NEW YORK
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State | NY
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Zip | 10024-6448
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Country | US
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Telephone | 954-895-1422
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Fax |
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Provider Business Mailing Address
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Address Line | 147 W 79TH ST APARTMENT 8 C
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City | NEW YORK
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State | NY
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Zip | 10024-6448
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 022243
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 022243
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License Number State | NY
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