=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972962504
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TARA ANNE MCCABE N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/10/2016
-----------------------------------------------------
Last Update Date | 05/31/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 240 EAST 38TH STREET 19TH FLOOR
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-501-4877
-----------------------------------------------------
Fax | 646-754-7608
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 240 E 38TH ST 19TH FLOOR
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-2708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-501-4877
-----------------------------------------------------
Fax | 646-754-7608
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ00720600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 340299
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------