Provider Demographics
NPI:1528329794
Name:FARINA, TARA DENISE (RN)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:DENISE
Last Name:FARINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 HIGHLAND AVE
Mailing Address - Street 2:UNIT A
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-6019
Mailing Address - Country:US
Mailing Address - Phone:845-795-6112
Mailing Address - Fax:
Practice Address - Street 1:220 HIGHLAND AVE
Practice Address - Street 2:UNIT A
Practice Address - City:MARLBORO
Practice Address - State:NY
Practice Address - Zip Code:12542-6019
Practice Address - Country:US
Practice Address - Phone:845-625-3209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY646816163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse