National Provider Identifier
Tara Andrea Providence, MD
Tara Andrea Providence, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Buffalo, NY and a listed phone number of (716) 898-4578.
Profile Overview
- NPI
- 1942697792
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- April 20, 2015
- Last Updated
- September 23, 2015
Practice Location
- 462 Grider St.
- David K. Miller Bldg.
- Buffalo, NY 14215
Phone: (716) 898-4578
Mailing Address
- 462 Grider St
- David K. Miller Bldg.
- Buffalo, NY 14215
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1942697792
- Entity Type
- Individual
- Last Name
- Providence
- First Name
- Tara
- Middle Name
- Andrea
- Name Prefix
- Miss
- Credential
- MD
- Mailing Street Address
- 462 Grider St
- Mailing Address Line 2
- David K. Miller Bldg.
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14215
- Mailing Country
- US
- Mailing Phone
- (716) 898-4578
- Mailing Fax
- (716) 898-3279
- Practice Street Address
- 462 Grider St.
- Practice Address Line 2
- David K. Miller Bldg.
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14215
- Practice Country
- US
- Practice Phone
- (716) 898-4578
- Practice Fax
- (716) 898-3279
- Enumeration Date
- April 20, 2015
- Last Updated
- September 23, 2015
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)