MEDICARE: DR. TARA LYNNE BUCHAKJIAN DC

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
1	111N00000X	Chiropractor	DC009377	PA
2	111NP0017X	Pediatric Chiropractor	DC009377	PA

General Provider Information

NPI Number	:	1639172380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARA LYNNE BUCHAKJIAN DC

Provider Business Mailing Address
First Line	:	2 HOME RD
Second Line	:	P.O.BOX 508
City	:	HATBORO
State	:	PA
Zip	:	19040-2026
Country	:	US
Telephone Number	:	215-444-0441
Fax Number	:	215-394-5428

Provider Business Practice Location Address
First Line	:	2 HOME RD
Second Line	:
City	:	HATBORO
State	:	PA
Zip	:	19040-2026
Country	:	US
Telephone Number	:	215-464-6922
Fax Number	:	215-394-5428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	04/16/2013

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