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NPI Code Detail

MEDICARE: TARA NIELSEN OSC

MEDICARE: TARA NIELSEN OSC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1144940156
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA NIELSEN OSC
Provider Business Mailing Address
First Line : PO BOX 6
Second Line :
City : BELLPORT
State : NY
Zip : 11713-0006
Country : US
Telephone Number : 631-286-0343
Fax Number : 631-569-2007
Provider Business Practice Location Address
First Line : 12 MORICHES ISLAND RD
Second Line :
City : EAST MORICHES
State : NY
Zip : 11940-1364
Country : US
Telephone Number : 516-449-0534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2022
Last Update Date : 08/30/2022

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