Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TARA BROCCOLO
Active Sole ProprietorTARA BROCCOLO is a Specialist healthcare provider located in IRONDEQUOIT, New York. NPI 1821495581 is currently active in the NPPES registry. Verify at CMS.
Specialist · IRONDEQUOIT, NY
Registration Details
- NPI Number
- 1821495581
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 24, 2014 (11.710375344875 yrs)
- Last Updated
- Nov 24, 2014
- License
-
649366951 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2111 HUDSON AVEIRONDEQUOIT, NY, 146174346Browse NY providers · Browse ZIP 14617
- Phone
- 5855201783
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in IRONDEQUOIT, NY
| Name | Credential | NPI |
|---|---|---|
| LAUREN RITZLER | — | 1093170227 |
| MOLLY PECK | — | 1073969655 |
| ANDREA SCALZO | — | 1124470414 |
| MRS. ANDREA SUNDLOF-STOLLER | M.S. ED,M.S. C.A.S | 1700327038 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.