Provider Demographics
NPI:1215256342
Name:BURCROFF, TARA L (AAHCC)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:L
Last Name:BURCROFF
Suffix:
Gender:F
Credentials:AAHCC
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:L
Other - Last Name:BURCROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1526 MEADOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:14425-9346
Mailing Address - Country:US
Mailing Address - Phone:585-398-3008
Mailing Address - Fax:
Practice Address - Street 1:1526 MEADOWBROOK LN
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NY
Practice Address - Zip Code:14425-9346
Practice Address - Country:US
Practice Address - Phone:585-398-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula