Most Relevant Information
Provider Data
| NPI Number: | 1003696436 |
| Provider Name: | TARA SANDERS PT |
| Entity Type: | Individual |
| Taxonomy Code: | 208100000X |
| Specialty: | Physical Medicine & Rehabilitation |
| License Number: | 011358-1 |
Most Important Dates
| Enumeration Date: | 10/03/2023 |
| Last Updated: | 10/03/2023 |
Provider Practice Location
16 HEMLOCK DR
GLEN HEAD
NY
115453325
Practice Location Phone/Fax
| Phone: | 9176126126 |
| Fax: |
Provider Mailing Location
16 HEMLOCK DR
GLEN HEAD
NY
115453325
Provider Mailing Phone/Fax
| Phone: | 9176126126 |
| Fax: |