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General NPI Number Information
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NPI Number | 1396279436
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Entity Type | Individual
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Provider Name | JOHN P TARAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2017
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 1181 NJ-36
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City | HAZLET
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State | NJ
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Zip | 07730
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Country | US
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Telephone | 619-913-3995
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Fax |
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Provider Business Mailing Address
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Address Line | 57 CREAMERY RD
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City | COLTS NECK
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State | NJ
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Zip | 07722-1512
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Country | US
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Telephone | 619-913-3995
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 159678
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MA12427000
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License Number State | NJ
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