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General NPI Number Information
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NPI Number | 1598901027
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Entity Type | Individual
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Provider Name | TARA C FORD PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 275-277 FOREST AVE STE 125
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City | PARAMUS
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State | NJ
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Zip | 07652-5423
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Country | US
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Telephone | 551-278-5898
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Fax |
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Provider Business Mailing Address
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Address Line | 18 EAGLE TER
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City | WEST ORANGE
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State | NJ
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Zip | 07052-5006
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Country | US
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Telephone | 631-766-0025
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 25MP00651000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 012199
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License Number State | NY
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