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General NPI Number Information
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NPI Number | 1760744486
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Entity Type | Organization
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Legal Business Name | TCACACE INC.
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 71 CRANFORD ST
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City | STATEN ISLAND
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State | NY
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Zip | 10308-3027
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Country | US
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Telephone | 718-702-8380
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Fax |
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Provider Business Mailing Address
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Address Line | 71 CRANFORD ST
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City | STATEN ISLAND
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State | NY
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Zip | 10308-3027
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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 | PRESIDENT
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Name | MRS. TARA ANN CACACE
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Credential | MS., ED.
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Telephone | 718-702-8380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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