Provider Demographics
NPI:1386291474
Name:SCHIUMO, TARA
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:SCHIUMO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 ASCOT CIR
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1808
Mailing Address - Country:US
Mailing Address - Phone:716-597-5898
Mailing Address - Fax:
Practice Address - Street 1:38 ASCOT CIR
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1808
Practice Address - Country:US
Practice Address - Phone:716-597-5898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18992225100000X
NY043403225100000X
GAPT013816225100000X
VA230512388225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist