Provider Demographics
NPI:1962762062
Name:BARCIA, TARA CHRISTINE (DO)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:CHRISTINE
Last Name:BARCIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34 E MONTAUK HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-1866
Mailing Address - Country:US
Mailing Address - Phone:631-728-0505
Mailing Address - Fax:631-728-4038
Practice Address - Street 1:34 E MONTAUK HWY STE 4
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-1866
Practice Address - Country:US
Practice Address - Phone:631-728-0505
Practice Address - Fax:631-728-4038
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04243032Medicaid
NY04243032Medicaid